Modern Care Journal

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Background and objectiveLow blood pressure and muscle cramps are the most common complications of hemodialysis. These complications during hemodialysis cause patient intolerance. One approach that has recently been proposed to prevent this complication of dialysis is to change dialysate sodium concentration and remove the velocity of fluid, a procedure called sodium-ultrafiltration profile. The purpose of this study was to investigate the effect of linear sodium-ultrafiltration profile on the patient's tolerance during hemodialysis.  Material and MethodsThis was a clinical trial with a crossover design. 30 hemodialysis patients referring to Be’sat Hemodialysis Center in Hamadan who had inclusion criteria were selected. Each of the patients received routine treatment for two sessions (where dialysate sodium concentration of 138 mmol/l remains constant from the first to the last day of dialysis, and ultrafiltration rate will not change) and two sessions of Profile 1 Na plus profile 1 ultrafiltration upon the physician’s order (sodium concentration dialysate at the beginning of dialysis was 146 mmol/l which was linearly decreased at the end of dialysis to 138 mmol/l ultrafiltration also decreased in an automated and linear manner over dialysis). Data were analyzed in SPSS (version 16) using Paired t -Test, ANOVA with repeated observations, Tukey Post Hoc and Wolcoxon.  ResultsThe mean age of patients was 50.83±16.71 years, and 53.3% were female. The results showed that the incidence of hypotension was significantly reduced during linear profiles, as compared with controls (P<0.05). And comfort level in the linear profile sodium-ultrafiltration was more. However, there was no significant difference between the incidences of muscle cramps in the two procedures.  ConclusionGiven the simplicity, cost-effectiveness, and reduced complications of sodium and ultrafiltration profiles during dialysis, we recommend using sodium and UF profiles instead of the routine method.  

Keywords: Hemodialysis, Sodium profile, Ultrafiltration, Patient tolerance

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