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首页> 外文期刊>International Journal of Advanced Biotechnology and Research >Effect of Ascending and Descending Stepwise Dialysate Flow Rate Profileson Adequacy and Complications of Hemodialysis
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Effect of Ascending and Descending Stepwise Dialysate Flow Rate Profileson Adequacy and Complications of Hemodialysis

机译：血液透析的充分性和并发症的透析液流速逐步上升和下降的影响

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Background and Objective: In Iran, dialysis adequacy is low in more than 60% of hemodialysis patients.Dialysisinadequacyisa main cause of morbidity and mortality in dialysis patients.Resistance of filter boundary layer andpoor distribution of dialysate flow are important factors limitingthe adequacy.Ascending and descending stepwisedialysate flowrate profiles are two methods to improve fluid distribution and dialysis adequacy and each maydifferwith the other in terms of patient comfort andcomplications.Methodology: In this quasi-experimental,single group, pre- and post-intervention research,22 hemodialysispatients covered by the SpecialPatients Center of Zabol were dialyzed through the routine method (dialysate flowrate of 500 min/mL) andascending and descending stepwise dialysateflow rate profiles,while keeping constant allparameters(such as filter type, blood flow rate, type and concentration of dialysate, shift, etc.).The patients weredialyzed through each method for 2 sessions. To assess the adequacy of dialysis, BUN was measured at thebeginning and end of the second session of each method before and after dialysis.During the sixth sessions ofdialysis, patients were checked before dialysis in terms ofblood pressure, symptoms such as nausea,vomiting,muscle cramps,headaches, and other symptoms andthen their blood pressure, nausea, vomiting,muscle cramps,and headaches were directly monitored every 30 minutes.Findings: The mean score of dialysis adequacy was 0.834±0.22 in the routine method,1.0032±0.28 in theascending stepwise dialysate flow rate profile, and1.07±0.35 in the descending stepwise dialysate flow rateprofile.According to paired t-test,the difference between routine and each of the stepwise profiles was significant(p=0.000).But there was no significant difference between routine and stepwise dialysate flow rate profile in termsof complications (headache, muscle cramps, nausea, vomiting, etc.)(p<0.05).There was no significant differencebetween the mean scores of dialysis adequacy in ascending and descending stepwise dialysate flow rateprofiles(p=0.346), however, according to chi-square test, a significant difference existed between these twoprofiles in terms of complicationssuch as headache (p=0.026).Conclusion:The stepwise dialysate flow rate profileis an efficient method for increasing dialysis adequacy andtheascending stepwise profileis more appropriate to improve dialysis adequacy than the routine method due toinsignificant complications,and thanthe descending stepwise profile due to lower complications.
机译：背景与目的：在伊朗，超过60％的血液透析患者的透析充足率较低。透析不足是透析患者发病和死亡的主要原因。过滤器边界层的阻力和透析液流量分配不良是限制透析充分性的重要因素。逐步透析液流速分布图是改善液体分配和透析充分性的两种方法，每种方法在患者舒适度和并发症方面可能彼此不同。 Zabol中心通过常规方法（透析液流量500 min / mL）透析，透析液流速分布曲线的上升和下降，同时保持所有参数不变（例如过滤器类型，血流速度，透析液类型和浓度，位移等）。 ）。通过每种方法对患者进行2次透析。为了评估透析的充分性，在透析前后每种方法的第二次开始和结束时测量BUN。在第六次透析期间，在透析前检查患者的血压，恶心，呕吐，肌肉等症状每30分钟直接监测一次抽筋，头痛和其他症状，然后对其血压，恶心，呕吐，肌肉抽筋和头痛进行监测。结果：常规方法中透析充分性的平均评分为0.834±0.22，升序为1.0032±0.28逐步透析液流速分布图，递减透析液流速分布图为1.07±0.35。根据配对t检验，例行程序和每种逐步分布图之间的差异是显着的（p = 0.000）。常规和逐步透析液流速分布在并发症（头痛，肌肉痉挛，恶心，呕吐等）方面的差异（p <0.05）。平均值之间无显着差异逐步透析液流速分布图的透析充分性评分（p = 0.346），但是根据卡方检验，这两种分布图在并发症（例如头痛）方面存在显着差异（p = 0.026）。结论：逐步法透析液流速分布图是提高透析充分性的一种有效方法，而由于并发症的发生率较低，因此，与常规方法相比，逐步分布图更适合于提高透析充分性，而由于并发症的减少，逐步分布图则是逐步下降的分布。

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