在接受常规血液透析的患者中，较高的超滤率与较长的透析恢复时间相关。

Higher Ultrafiltration Rate Is Associated with Longer Dialysis Recovery Time in Patients Undergoing Conventional Hemodialysis.

作者信息

Hussein Wael F, Arramreddy Rohini, Sun Sumi J, Reiterman Marc, Schiller Brigitte

机构信息

Department of Medicine, Division of Nephrology, Stanford University, Palo Alto, CA, USA.

出版信息

Am J Nephrol. 2017;46(1):3-10. doi: 10.1159/000476076. Epub 2017 May 30.

DOI:10.1159/000476076

PMID:28554180

Abstract

BACKGROUND

Increased mortality and morbidity are reported in association with high ultrafiltration rate (UFR) and with long dialysis recovery time (DRT). We studied the association between UFR and DRT.

METHODS

This is a cross-sectional, observational study was conducted. Patients on thrice-weekly hemodialysis (HD) with self-reported DRT between August and December 2014 were included. We examined the association of 30-day average UFR with recovery time.

RESULTS

The total number of patients included in this study was 2,689. DRT in categories of immediate recovery, >0-≤2, >2-≤6, >6-≤12, and >12 h, were reported in 27, 28, 17, 9, and 20% of the patients respectively. In multivariable analysis, longer DRT was associated with female gender, non-black race, higher body weight, lower serum albumin, chronic heart failure, cerebrovascular disease, missed dialysis sessions, higher pre-dialysis systolic blood pressure, and larger UF volume. Compared to UFR of <10, UFR ≥13 mL/kg/h was associated with longer DRT, OR of 1.16 (95% CI 0.99-1.36), and 1.28 (95% CI 1.06-1.54) in the unadjusted and the adjusted analyses respectively. Intradialytic hypotension was also associated with longer DRT in the unadjusted (per 10% higher frequency, OR 1.04 [95% CI 1.01-1.07]) and adjusted analyses (OR 1.03 [95% CI 1.00-1.07]).

CONCLUSION

Long recovery time is common after HD. Rapid fluid removal is associated with longer DRT.

摘要

背景

据报道，高超滤率（UFR）和长透析恢复时间（DRT）与死亡率和发病率增加相关。我们研究了UFR与DRT之间的关联。

方法

进行了一项横断面观察性研究。纳入2014年8月至12月期间每周进行三次血液透析（HD）且自我报告有DRT的患者。我们检查了30天平均UFR与恢复时间的关联。

结果

本研究纳入的患者总数为2689例。分别有27%、28%、17%、9%和20%的患者报告即时恢复、>0至≤2小时、>2至≤6小时、>6至≤12小时和>12小时的DRT。在多变量分析中，较长的DRT与女性、非黑人种族、较高体重、较低血清白蛋白、慢性心力衰竭、脑血管疾病、错过透析次数、透析前较高收缩压和较大超滤量相关。与UFR<10相比，UFR≥13 mL/kg/h在未调整和调整分析中分别与较长的DRT相关，比值比分别为1.16（95%可信区间0.99 - 1.36）和1.28（95%可信区间1.06 - 1.54）。透析中低血压在未调整（每增加10%频率，比值比1.04 [95%可信区间1.01 - 1.07]）和调整分析（比值比1.03 [95%可信区间1.00 - 1.07]）中也与较长的DRT相关。