بررسی تاثیر تغییر غلظت سدیم محلول دیالیز همراه با تغییر سرعت اولترافیلتراسیون بر افت فشارخون حین دیالیز و وزن بین جلسات دیالیز

Background and purpose:Intradialytic hypotension (IDH) is the most frequent complicationin patients receiving haemodialysis (HD) that poses most problems for patient and treatment team. The use of sodiumprofile and ultra filtration (UF) profile is one of the preventive methods that have been recently introduced. However, increased intradialytic weight gain (IDWG) has been described as the side effect of this method. The aim of thisstudy was to evaluate the effects of linear and stepwise sodium and UF profile on Intradialytic hypotension and IDWG. Materials and methods: This was a clinical trial study and crossover design. Twenty- six stable HD patients from two dialysis centers (Ali Asghar and Alzahra Hospitals) of Esfahan Universityunderwent three treatments: (1) control, constant dialysate sodiumconcentration of 138 mmol/l with constant UF (2) linearsodium profile + UF profile (type1), a linearly decrease dialysate sodium concentration (146–138mmol/l) combination with a linearly decreaseUF rate. (3) Stepwise sodium profile + UF profile (type2), a stepwise decrease dialysate sodium concentration (146-138mmol/l) combination with a stepwise decreaseUF rate. Data were analyzed using χ2 and independent t-test in SPSS software. Results:In this study, a total of 26 patients (14 men, and 12 females) participated. The mean age 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, while receiving an intervention, wassignificantly reduced during linear and stepwise profiles, as compared with control (P<0.05, respectively). However, there was no significant differences between profiles. IDWG did not show any changes during three group. Conclusion: Sodium profile and UF profile modulates the dialysate sodium concentration and ultra filtration rate and also, prevents the incidence of IDH while reducing nursing intervention, without increasing IDWG. Thus, using sodium profile and UF profile groups (linear and stepwise) is recommended for the prevention of hypotension, as compared to routine method.