title: Reducing complications during hemodialysis using gradient ultrafiltration with gradient sodium dialysate.
abstract: The objective of this study was to determine if patient complications and nursing interventions during hemodialysis could be reduced using gradient ultrafiltration and gradient sodium dialysate. Twenty outpatients who had been on hemodialysis for at least 3 months, and using gradient sodium dialysate for at least 1 month, participated. Patients received either ultrafiltration at a constant hourly rate or gradient ultrafiltration, in which the ultrafiltration rate was set higher initially, then decreased step-wise mid-dialysis. Patients received each protocol for 3 months, using a randomized cross-over design. Both protocols used gradient sodium dialysate (150 mEq/L x 3 hrs, 140 mEq/L x 1 hr). There were significantly fewer complications and interventions using gradient ultrafiltration, as compared to constant ultrafiltration. No differences were found in interdialytic weight gain, intradialytic weight loss, or orthostatic blood pressure. These results indicate that gradient ultrafiltration combined with gradient sodium dialysate enhances patient well-being and reduces nursing interventions during hemodialysis.
authors.affiliation: ESRD Program, Kingston Hospital, Ontario, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Meers
authors.forename: E B
authors.initials: EB
authors.lastname: Toffelmire
authors.forename: M
authors.initials: M
authors.lastname: McMurray
authors.forename: W
authors.initials: W
authors.lastname: Hopman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015400:Clinical Nursing Research; D018592:Cross-Over Studies; D015314:Dialysis Solutions / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D017583:Hemodiafiltration / Q000009:adverse effects* / Q000379:methods* / Q000451:nursing; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000008:administration & dosage*; D015431:Weight Loss
chemical_list: D015314:Dialysis Solutions; D012964:Sodium