Study on the effects of different patterns of dialysis in prevention of hemodialysis-associated hypotension

Objective To compare the effects of four dialysis patterns in prevention of hypotension during hemodialysis(HD).Methods Forteen cases of maintenance hemodialysis patients who had episodes of hypotension during hemodialysis were enrolled for study by single blind self-control design.After 8 times of routine HD,3 other patterns of dialysis were employed for the same patient in succession,each for 8 times.Pattern 1: Ultrafiltration plus HD: single ultrafiltration for 30 minutes followed by 4-hour routine HD; Pattern 2: Natrium gradient HD : natrium concentration in dialysate between 135～150 mmol/L: Pattern 3: Natrium gradient plus ultrafiltration gradient HD.Results Compared with routine HD,the occurrence of hypotension and frequency of nursing interference were declined remarkably in pattern 2 and 3(P0.01).There was no significant difference in blood pressure before the use of each pattern of dialysis(P0.05).The difference of blood pressure before dialysis and that at the end of dialysis or the lowest blood pressure during dialysis by pattern 3 had statistical significance(P0.05),compared with that of routine HD,pateern 1 and 2.Pattern 1 was noticeably ineffective in the prevention of hypotension during hemodialysis(P0.05).Conclusion For patients who suffered from frequent attacks of hypotension during hemodialysis,the pattern of natrium gradient plus ultrafiltration gradient HD(pattern 3) to be the first choice seemed and natrium gradient HD(pattern 2) the second in treatment.Single ultrafiltration plus HD(patten 1) has no obvious effect in prevention of hypotension during hemodialysis.