Adequacy of twice weekly hemodialysis in end stage renal disease patients at a tertiary care dialysis centre.
Adequacy of twice weekly hemodialysis in end stage renal disease patients at a tertiary care dialysis centre.
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DOI：
10.4103/0971-4065.151762
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发表时间：
2015-11-01
影响因子：
0.8
通讯作者：
Mendonca, S
中科院分区：
文献类型：
--
作者：
Chauhan, R;Mendonca, S
血液透析改善了终末期肾病的发病率和死亡率。在印度，血液透析处方是经验性的，这会导致与透析不足相关的并发症。因此，本研究分析了印度环境中血液透析的充分性。共对50例每周两次血液透析的患者进行了为期1个月的评估。计算符合肾脏疾病结局质量倡议（KDOQI）指南规定的标准的会议次数。他们被分为两组：一组进行透析监测，并增加疗程长度，以满足最低标准Kt/V为2，第二组为对照组;不监测Kt/V。6个月后比较两组患者的血红蛋白（Hb）、白蛋白（ALB）、平均动脉压（MAP）及世界卫生组织（WHO）生活质量（QoL）评分。根据KDOQI指南，只有28%的血液透析疗程是充分的。与对照组相比，研究组的Hb水平（1.47 vs. 0.15 g/dl）、平均动脉压水平（15.2 vs. 3.16 mm Hg）、血清白蛋白水平（0.82 vs. 0.11 g/dl）和WHO QoL评分（17.2 vs. 2.24）均有显著改善。标准Kt/V可用作修改每周两次透析疗程的重要工具，以向患者提供更好的QoL。然而，需要更大样本量的研究来最终证明我们的结果。
Hemodialysis has improved the morbidity and mortality associated with end stage renal disease. In India, hemodialysis prescription is empiric, which leads to complications related to under-dialysis. Hence, adequacy of hemodialysis in Indian setting was analyzed in this study. A total of 50 patients on twice per week hemodialysis were assessed for 1 month. The number of sessions meeting standards laid out by Kidney Diseases Outcome Quality Initiatives (KDOQI) guidelines were calculated. They were divided into two groups: one in whom dialysis was monitored and session length enhanced to meet the minimum standard Kt/V of 2 and second control group; where Kt/V was not monitored. Hemoglobin (Hb) levels, albumin levels, mean arterial pressure and World Health Organization (WHO) quality of life (QoL) score were compared in the two groups after 6 months. Only 28% of hemodialysis sessions were adequate as per KDOQI guidelines. There was significant improvement in Hb levels (1.47 vs. 0.15 g/dl), mean arterial pressure levels (15.2 vs. 3.16 mm Hg), serum albumin levels (0.82 vs. 0.11 g/dl) and WHO QoL score (17.2 vs. 2.24) in study group as compared to control group. Standard Kt/V can be used as an important tool to modify twice weekly dialysis sessions to provide better QoL to the patients. However, studies with larger sample size are required to conclusively prove our results.