Nursing Research of Ultrafiltration Profiling and Measurement of Relative Blood Volume as Strategies to Reduce Hemodialysis-Related Side Effects

Objective To observe the effects of ultrafiitration ( UF ) profiling and measurement of relative blood volume(RBV) as strategies to reduce hemodialysis (HD) -related side effects. Methods 238 dialysis sessions in 68 patients with histories of symptomatic hypotension were followed up from 2001 to 2002 at Xinqiao Hospital Center of Dialysis. Six UF profiles were examined in 238 HD sessions; UF profile 0, with a constant UF rate; UF profile 1, with a linear decreasing UF rate; UF profile 2, with a step-wise decreasing UF rate; and UF profiles 3 through 5, with intermittent high UF rates interrupted by UF pauses. RBV was also measured with a blood volume monitor during HD sessions. Results The incidence of symptomatic hypotension of patients was found to be lower in UFO and UF1 groups than that in UF2 - UF5 groups, and which of UF1 was the lowest in all UF profiles. The occurrences of muscle cramps, vomiting,fatigue, and headache were significantly high during the treatment in UF2 - UF5 groups compared with UFO and UF1 groups ( P 0. 05). RBV values of patients with hypotensive episodes were significantly lower than those of patents with symptomatic episodes during HD treatments ( P 0. 05 ). Minimal RBV (mRBV) below 88% often was a predictor for occurrence of symptomatic hypotension during HD sessions. Conclusion UF profile with a linear decreasing UF rate may prove to be very helpful in decreasing the occurrence of HD-related symptomatic hypotension. RBV measurement may also help predict the appearance of symptomatic hypotension.