단계적 초여과법과 고나트륨 투석액이 혈액투석 중의 부작용 감소에 미치는 효과

초록

Objective:The objective of this study was to determine whether complications and nursing interventions during hemodialysis could be reduced by using gradient ultrafiltration(GUF) and high sodium dialysate(HSD). Methods:Thirty outpatients who had been on hemodialysis for more than 3 months were enrolled. Patients received Conventional HD(Na＋ 137 mEq×4 hrs, constant UF), GUF(UF 62.5%×2 hrs, UF 37.5 %×2 hrs), HSD(Na＋ 145 mEq×2 hrs, Na＋ 140 mEq×2 hrs) and HSUF(GUF & HSD). Each methods were prescribed for 2 weeks. The clinical features such as thirst, interdialytic weight gain, postdialytic weight loss and MAP(mean arterial pressure) and the frequency of intradialytic complications and nursing interventions were evaluated. Results:The results were as followings. Interdialytic thirst, weight gain, postdialytic weight loss and MAP(pre/post HD) were not significantly different in each method. On the other hand, there was significant difference between 4 methods in serum sodium, osmolality and Hct. There were significantly fewer episodes of hypotention, muscle cramp and headache when using GUF, HSD and HSUF than CHD. The number of nursing interventions was significantly reduced in GUF, HSD and HSUF than CHD. Conclusion:Hemodialysis with gradient ultrafiltration and high sodium dialysate leads fewer complications and nursing interventions, more patient's well being.

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