A Study on the High-risk Patients with Dialysis Hypotension Prevented Through Sodium Profile in the Low Temperature

Objective Intradialytic hypotension(IDH) is a morbid complication of hemodialysis(HD),which frequently happened in the high-risk groups(high-age,diabetic nephropathy,cancer,cardiac insufficiency,etc.).In this paper the author investigates the effect of sodium profile dialysis in low temperature on controlling hypotension.Methods Ten uremic high-risk patients receiving regular bicarbonate hemodialysis were chosen as examples.Hemodialysis patterns:constant sodium hemodialysis(CHD),high-low sodium hemodialysis(H-LHD),and combination therapy phase(H-LHD,and cool dialysate).In CHD,sodium concentration of the dialysate was 140 mmol/L.In H-LHD,sodium concentration of the dialysate in the beginning of dialysis was 148-155 mmol/L,and remain constant for 60 min.Sodium concentration of the dialysate changed according to a model to keep identical when the amo-unt of dialysate sodium exchanged in the different dialysis porocedures.At the end of dialysis the sodium concentration was 135 mmol/L.In low temperature phase,it was 35.5℃-36℃,which was different from the 37℃ in the other two phases.Each phase consisted of ten consecutive HD treatment.The duration of hemodialysis,the blood flow rate,the dialysate flow rate,and the dialysis membrane were the same for all three different hemodialysis modalities.Total dialysate collection and intradialytic sodium balance were calculated for each hemodialysis session.Results The results have shown that in the three different hemodialysis treatments phases there were no statistically difference between sodium concentration of the dialysis before and after the dialysis(P0.05).There was a significant reduction in the amount of IDH in the H-LHD alone and that combinated with cool dialysate compared with control group.There was a trend toward improvement of hypotensive symptoms by both therapies.Conclusion This prospective study shows that PHD is effective therapies for symptomatic IDH.It does not show the additional benefit when these two therapies are used in combination.