Comparison of the Effect of Linear and Stepwise Sodium and Ultrafiltration Profiling on Dialysis Adequacy in Patients undergoing Hemodialysis

Abstract

Abstract: Patients with chronic renal failure (CRF) undergoing hemodialysis need to receive adequate dialysis. Dialysis inadequacy leads to an increase in the side effects and even frequent hospitalizations as well as increased therapeutic costs. Considering the fact that improving the adequacy of dialysis is one of the goals of nursing care in these patients, this study aimed to compare the effect of linear and stepwise sodium-ultrafiltration profiling on hemodialysis adequacy. this study is clinical trial, a total of 32 patients from two dialysis centers in East Azerbaijan province were selected and randomly divided into two groups. Each patient underwent hemodialysis for three sessions by routine method, three sessions by linear sodium profile and ultrafiltration, and three sessions by the stepwise sodium profile and ultrafiltration. At the end of each hemodialysis method, Kt/V was calculated to determine the adequacy of dialysis. Data analysis was performed using SPSS-13 software with GEE statistical test. According to the results of this study there was a significant difference between the mean of adequacy of dialysis (Kt/V) in the three treatment methods (P <0.05); in which the mean score of dialysis adequacy in stepwise method was 0.14 more than routine, and in linear method, it was 0.21 more than routine method. The mean Kt/V scores were 1.24, 1.31 and 1.10 in the stepwise method, linear method and routine method, respectively (P <0.05). The results of this study indicate that simultaneous application of sodium and ultrafiltration profiles is effective in hemodynamic stability of patients, and reduces uncomfortable complications during dialysis. Therefore, in order to improve dialysis adequacy and prevent the complications, using of sodium and ultrafiltration profiles is recommended.