Korean Journal of Adult Nursing (성인간호학회지)
- Volume 12 Issue 1
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- Pages.88-98
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- 2000
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- 1225-4886(pISSN)
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- 2288-338X(eISSN)
The Effect of Hypertonic Dialysate on Hemodynamic Parameters (blood pressure, pulse rate, ultrafiltration rate), Interdialytic Weight Gain and the Incidence of Thirst with Hemodialysis Patients
말기신부전증 환자에서 혈액투석액 나트륨 농도가 혈압, 투석간 체중증가 및 갈증에 미치는 영향
- Park, Hye Ja (School of Nursing, Pochun Joongmun Medical College) ;
- Jang, Eun Jung (Department of Nursing, Kyungbok College) ;
- Kim, Mi Kyung (Hemodialysis Room, Kang Nam St. Mary's Hospital, Catholic University) ;
- Jo, Nam Mi (Hemodialysis Room, Kang Nam St. Mary's Hospital, Catholic University)
- Published : 2000.03.30
Abstract
Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain & thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I (p=0.04). 2. Incidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during hemodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group I(