بررسي تاثير پروفايل هاي خطي و پلكاني سديم و اولترافيلتراسيون بر افت فشارخون و كرامپ هاي عضلاني حين همودياليز

Effect of linear and stepwise sodium and ultra filtration profiles on intradialytic hypotension and muscle cramps in renal disease patients

Background and aims. Intradialytic hypotension and muscle cramps are most frequent complications in patients receiving haemodialysis (HD). So, preventing of these complications is one of the main challenges of the treatment team, especially for nurses. One of the preventive methods that have been recently introduced is the use of sodium profile and ultra filtration (UF) profile. The aim of this study was to evaluate the effects of two types of sodium and UF profiles on Intradialytic hypotension and muscle cramps. Methods: In this clinical trial study, twenty six stable HD patients from two dialysis centers (Ali Asghar and Al-Zahra Hospitals) of Isfahan University underwent three different treatments: (1) control, constant dialysate sodium concentration of 138 mmol/1 with constant UF, (2) linear sodium profile + UF profile (typel), a linearly decreasing dialysate sodium concentration (146-138mmol/l) combination with a linearly decreasing UF rate. (3) a stepwise sodium profile 4- UF profile (type2), a stepwise decreasing dialysate sodium concentration (146-138 mmol/1) combination with a stepwise decreasing UF rate. Each treatment was applied in 3 dialysis sessions. Data were analyzed using %2 test using SPSS software. Results: A total of 26 patients (14 men, 12 female) were participated in this study. The mean age of patients was 46.8±19 years. In each group, 78 dialysis sessions and a total of 234 dialysis sessions were analyzed. The incidence of intradialytic hypotension and cramps was significantly reduced during two type of profiles compared with control group (P<0.05, respectively). However, there was no significant differences between profiles (P>0.05). Conclusions: Sodium profile and UF profile are simple and cost effective method that modulate the dialysate sodium and ultrafiltration rate and preserve the homodynamic status of patients during dialysis. So, using of sodium profile and UF profile groups (linear and stepwise) is recommended for prevention of hypotension and cramps during dialysis process.