Hamidi Mehri, Roshangar Fariborz, Khosroshahi Hamid Tayebi, Hadi Hassankhani, Ghafourifard Mansour, Sarbakhsh Parvin
Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz, Iran.
Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Saudi J Kidney Dis Transpl. 2020 Jan-Feb;31(1):44-52. doi: 10.4103/1319-2442.279960.
Patients with chronic renal failure undergoing hemodialysis (HD) need to receive adequate dialysis. Dialysis inadequacy leads to an increase in the side effects and even frequent hospitalizations as well as increased therapeutic costs. Considering the fact that improving the adequacy of dialysis is one of the goals of nursing care in these patients, this study aimed to compare the effect of linear and step-wise sodium-ultrafiltration (UF) profiling on HD adequacy. This study is a clinical trial; a total of 32 patients from two dialysis centers in East Azerbaijan province were selected and randomly divided into two groups. Each patient underwent HD for three sessions by routine method, three sessions by linear sodium profile and UF, and three sessions by the step-wise sodium profile and UF. At the end of each HD method, Kt/V was calculated to determine the adequacy of dialysis. Data analysis was performed using Statistical Package for the Social Sciences software version 13 with generalized estimating equation statistical test. According to the results of this study, there was a statistically significant difference between the mean of adequacy of dialysis (Kt/V) in the three treatment methods (P <0.05), in which the mean score of dialysis adequacy in step-wise method was 0.14 more than the routine method, and in the linear method, it was 0.21 more than the routine method. The mean Kt/V scores were 1.24, 1.31, and 1.10 in the step-wise method, linear method, and routine method, respectively(P <0.05). The results of this study indicate that simultaneous application of sodium and UF profiles is effective in the hemodynamic stability of patients, which reduces uncomfortable complications during dialysis. Therefore, in order to improve dialysis adequacy and prevent the complications, usage of sodium and UF profiles is recommended.
接受血液透析（HD）的慢性肾衰竭患者需要接受充分的透析治疗。透析不充分会导致副作用增加，甚至频繁住院以及治疗费用增加。鉴于改善透析充分性是这些患者护理的目标之一，本研究旨在比较线性和阶梯式钠超滤（UF）模式对HD充分性的影响。本研究是一项临床试验；从东阿塞拜疆省的两个透析中心共选取了32例患者，并随机分为两组。每位患者分别采用常规方法进行3次HD治疗、采用线性钠模式和UF进行3次HD治疗、采用阶梯式钠模式和UF进行3次HD治疗。在每种HD方法结束时，计算Kt/V以确定透析充分性。使用社会科学统计软件包第13版和广义估计方程统计检验进行数据分析。根据本研究结果，三种治疗方法的透析充分性（Kt/V）平均值之间存在统计学显著差异（P<0.05），其中阶梯式方法的透析充分性平均得分比常规方法高0.14，线性方法比常规方法高0.21。阶梯式方法、线性方法和常规方法的平均Kt/V得分分别为1.24、1.31和1.10（P<0.05）。本研究结果表明，同时应用钠和UF模式对患者的血流动力学稳定性有效，可减少透析期间的不适并发症。因此，为了提高透析充分性并预防并发症，建议使用钠和UF模式。
