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- 저자 : 원삼순;.윤현정;조성이;이세영;이경은;박미주 (검색결과 1 건)
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개별화된 투석액 나트륨 농도 조절이 투석환자의 혈압, 투석간 체중증가 및 갈증정도에 미치는 영향
원삼순;.윤현정;조성이;이세영;이경은;박미주 중앙대학교 의과대학 간호학과 간호과학연구소 2010 중앙간호논문집 Vol.14 No.-
Purpose: Current hemodialysis prescribing standards use dialysate sodium concenntration that are high relative to the patient's plasma sodium concentration. Generally each patient has a fixed osmolar set point. So, use of hypertonic sodium dialysate predispose to positive sodium balance, lead to higher blood pressure, interdialytic weight gain and thirst. Therefore, we designed a study to investigate the effects of individualized dialysate sodium concentration centration prescription based on pre-HD plasma sodium concentration on patient's blood pressure, interdialytic weight gain and thirst Methods: Thirty-eight HD patients were enrolled in this cross-over study. All the patients underwent nine consecutive HD sessions with the dialysate contained 138 mEq/L sodium (standard sodium HD), then concentrations of sodium were switched to match the patients average pre-HD plasrna sodium measured during the sodium standard phase (135mEq/L for patients with sodium levels less than 130mEq/L, 137mEq/L for patients with sodium levels over 138mEq/L). Results: Standard sodium dialysis and individualized sodium alignrnent of the physiological indices Hgb, Hct, Calcium. Kt / V, BUN, Cr and there were no differences, There was a significant decrease in the interdialytic weight gain (2.3 ± 0.8kg vs. 2.0±t 0.8kg, p <0.001). Alburnin 3.7±0.4 vs 3.8±0.3, plasma Na concentration of 137.8± 3.1 vs 136.1± 4.4. Blood pressure and pulse rate, weight gain between dialysis and hemodialysis blood pressure 140.9± 13.4 vs 131.8 ± 11.4, weight gain between dialysis 2.0± 0.8 vs 2.3± 0.8, systolic blood pressure after dialysis,. after dialysis, diastolic Blood pressure, pulse rate before and after hemodialysis, there was no difference in thirst. Conclusion: An individualized sodium dialysate based on predialysis plasma sodium levels decreases thirst, interdialytic weight gain, pre-HD SBP
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