Hamzi Amine Mohamed, Asseraji Mohamed, Hassani Kawtar, Alayoud Ahmed, Abdellali Bahadi, Zajjari Yassir, Montacer Dina Brahim, Akhmouch Ismail, Benyahia Mohamed, Oualim Zouhir
Department of Nephrology, Dialysis and Transplantation, Military Hospital Mohamed V, Rabat, Morocco.
Arab J Nephrol Transplant. 2012 Sep;5(3):129-34.
Intra-dialytic hypotension (IDH) is a common complication during hemodialysis (HD) treatment. Previous studies have reported that modulating dialysate sodium concentration combined or not with modulation of ultrafiltration (UF) rate may reduce the incidence of IDH. The aim of the present study was to evaluate the effect of sodium and UF profiles on the occurrence of intra-dialytic complications and dialysis quality.
From a total of 64 patients, we selected 18 patients who suffered from recurrent IDH. Every patient received ten HD sessions utilizing each of the following treatments: (1) CONTROL: constant sodium concentration and UF rates. (2) Sodium and UF profiles: a linearly decreasing sodium concentration combined with a linearly decreasing UF rate. (3) Sodium profile: decreasing sodium concentration with constant UF rate.
Fourteen patients completed the study protocol. The incidence of IDH, mean inter-dialytic weight gain and the delivered dialysis dose were not different between the three treatments. However, symptomatic episodes of IDH were more commonand pre-dialysis systolic blood pressure was higher during the second and third treatment modalities compared to controls. Isolated sodium profile was associated with more malaise and less achievement of target session duration compared to the other two treatments. Isolated sodium profile was associated with less achievement of target UF while combined sodium and UF profiles were associated with more achievement of target UF compared to controls.
Our results indicate that sodium profile with or without UF profile does not have a beneficial effect on the incidence of IDH, achievement of target session duration or the delivered dialysis dose. Keywords : Sodium Profile; Ultrafiltration; Intradialytic Complications.
透析中低血压（IDH）是血液透析（HD）治疗期间的常见并发症。先前的研究报告称，调节透析液钠浓度联合或不联合调节超滤（UF）率可能会降低IDH的发生率。本研究的目的是评估钠和超滤模式对透析中并发症的发生及透析质量的影响。
从64例患者中，我们选取了18例反复发生IDH的患者。每位患者接受十次HD治疗，每次治疗采用以下方法之一：（1）对照：钠浓度和超滤率恒定。（2）钠和超滤模式：钠浓度呈线性下降并联合超滤率呈线性下降。（3）钠模式：钠浓度下降但超滤率恒定。
14例患者完成了研究方案。三种治疗方法在IDH的发生率、透析间期平均体重增加量和透析剂量方面并无差异。然而，与对照相比，在第二和第三种治疗方式期间，IDH的症状性发作更为常见，且透析前收缩压更高。与其他两种治疗相比，单独的钠模式与更多的不适相关，且达到目标治疗时长的情况较少。与对照相比，单独的钠模式与达到目标超滤量的情况较少相关，而联合的钠和超滤模式与达到目标超滤量的情况较多相关。
我们的结果表明，无论有无超滤模式，钠模式对IDH的发生率、达到目标治疗时长或透析剂量均无有益影响。关键词：钠模式；超滤；透析中并发症
