Clinical effect of the ratio of two step ultrafiltration volume with time on excessive water retention in hemodialysis patients

Abstract

Objective To investigate the clinical effect of the ratio of two step ultrafiltration volume with time on excessive water retention in hemodialysis patients.Methods ①The high,low level step ultrafiltration patients were divided into group A,B and C according to different ultrafiltration volume and time,to test the best combination by comparing their result.②comparing the best combination of two step ultrafitration mode with linear,and unifom ultrafiltration mode.Dialysate sodium concentration of ① and ② were set to 140 mmol/L.Results In the three groups,high levels of ultrafiltration volume to total ultrafiltration volume 1/3 in group A,sttting time of 1 hour,completing the rest of ultrafiltration volume in low level time,had the best result.In threee types of dialysis ultrafiltration mode,dialysis 1 h mean arterial pressure (MAP) determination,two step less than linear,uniform ultrafiltratoin (P ＜0.05),but few episodes of symptomatic hypotension.Dialysis 2 h,two horizontal steps higher than the linear (P ＜ 0.05),3 h of dialysis,4 h or 4.5 h,two horizontal step higher than the linear,uniforn ultrafitration (P ＜ 0.05),linear than uniform ultrafitration.Dialysis 1 h biochemical assays,serum albumin,hemoglobin level of two ladder,hematocrit,plasma osmotic pressure was higher than linear,uniform ultrafitration (P ＜ 0.05).On the process of dialysis hypotension incidence and the corresponding clinical treatment and ultrafitration,uniform linear phase compared (P ＜ 0.05).Linear ultrafitration comorbidity occurred less than uniform ultrafitration.Conclusions Hemodialysis using two step ultrafiltration settings,can reduce the ultrafitration comorbidities,achieve the preset target value for most ultrafiltration,dialysis interval excessive water retention cases is applicable. Key words: Tow step ultrafiltration ; Hemodialysis ; Excessive water retention ; Linear ultrafiltration ; Uniform ultrafiltration ; Clinical comparison