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개별적 저나트륨 투석액 적용이 혈액투석 환자의 체중증가, 혈압 및 투석 중 부작용에 미치는 효과

The Effects of the Individual Application of Low Sodium Dialysate on Weight Gain, Blood Pressure, and Intradialytic Side Effects in Patients on Maintenance Hemodialysis

김은숙|이유나|송지숙
병원간호사회 (Hospital Nurses Association)|2013.04|임상간호연구 (Journal of Korean Clinical Nursing Research)|제19권 제1호|pp. 45-56

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키워드

혈압Blood pressure혈액투석체중증가Weight gainHemodialysis저나트륨 투석액Dialysis solutions
주제분류간호학

초록

Purpose: The purpose of this study is to identify the effect of low sodium dialysate (LSD) rather than conventional dialysate on interdialytic weight gain (IWG), blood pressure (BP), and intradialytic side-effects (ISEs) in patients on maintenance hemodialysis (HD). Methods: The study was performed in 43 patients, who were treated in the university hospital over 8 weeks. Each participant’s serum sodium set point was measured using dialysate sodium 140 mEq/L during the first 4 weeks. For the next 4 weeks dialysate sodium concentrate (134,136,and138 mEq/L) was provided to each participant but only to an experimental group (EG) (n=22)based on the individual set point, although 140 mEq/L dialysate was given to all of the control group (CG)(n=21). Consequently, outcomes including IWG, BP, and ISE were evaluated. Results: In EG, difference of pre-HD SBP (p=.047) and post-HD serum sodium (p=.006) were significantly decreased compared to CG. Also,ISEs was not more frequent in EG. However, the differences were not statistically significant, IWG (kg & %),pre-HD DBP, post-HD SBP & DBP, and serum osmolality in EG. Conclusion: Individual application of LSD in patients on maintenance hemodialysis is beneficial to decrease pre-HD SBP and post-HD serum sodium without increasing ISE. Therefore, LSD can be better treatment than conventional dialysate.

Abstract

Purpose: The purpose of this study is to identify the effect of low sodium dialysate (LSD) rather than conventional dialysate on interdialytic weight gain (IWG), blood pressure (BP), and intradialytic side-effects (ISEs) in patients on maintenance hemodialysis (HD). Methods: The study was performed in 43 patients, who were treated in the university hospital over 8 weeks. Each participant’s serum sodium set point was measured using dialysate sodium 140 mEq/L during the first 4 weeks. For the next 4 weeks dialysate sodium concentrate (134,136,and138 mEq/L) was provided to each participant but only to an experimental group (EG) (n=22)based on the individual set point, although 140 mEq/L dialysate was given to all of the control group (CG)(n=21). Consequently, outcomes including IWG, BP, and ISE were evaluated. Results: In EG, difference of pre-HD SBP (p=.047) and post-HD serum sodium (p=.006) were significantly decreased compared to CG. Also,ISEs was not more frequent in EG. However, the differences were not statistically significant, IWG (kg & %),pre-HD DBP, post-HD SBP & DBP, and serum osmolality in EG. Conclusion: Individual application of LSD in patients on maintenance hemodialysis is beneficial to decrease pre-HD SBP and post-HD serum sodium without increasing ISE. Therefore, LSD can be better treatment than conventional dialysate.

참고문헌 (28)

  1. 김애경, "혈액투석간호" (2006), 군자출판사
  2. 김문재, "혈액투석 환자에서 투석액의 소디움 농도 변화에 따른 투석 간 혈압의 변화", Kidney Research and Clinical Practice, 20(2), pp.169~179 (2001), 대한신장학회
  3. 김선민, "유지 혈액투석 환자에서 저나트륨 투석액의 효과", Kidney Research and Clinical Practice, 30(1), pp.53~60 (2011), 대한신장학회
  4. 김영재, "오심, 구토, 구역질 측정도구의 신뢰도와 타당도 검증", 성인간호학회지, 12(2), pp.278~285 (2000)
  5. 김용덕, "근육경련 섬유속성연축 증후군", 대한신경과학회지, 14(4), pp.1030~1034 (1996)
  6. 김정아, "단계적 초여과법과 고나트륨 투석액이혈액투석 중의 부작용 감소에 미치는 효과", Kidney Research and Clinical Practice, 21(3), pp.14~459 (2002), 대한신장학회
  7. "우리나라신대체요법의현황" (2010)[URL]
  8. 마경애, "다양한고염투석액을 이용한 혈액투석시 혈액량의 변화 및 부작용 발생의 관찰", 대한신장학회지, 18(3), pp.436~444 (1999)
  9. 박재석, "혈액투석을 받고 있는 환자에서 자발성 뇌출혈", 대한신경외과학회지, 30(SupplI), pp.S115~S119 (2001)
  10. 박혜자, "말기신부전증 환자에서 혈액투석액 나트륨 농도가 혈압, 투석간 체중증가 및 갈증에 미치는 영향", 성인간호학회지, 12(1), pp.88~98 (2000)
  11. 송호철, "고나트륨 투석액 혈액투석이 혈압에 미치는 영향", 대한신장학회지, 17(1), pp.104~109 (1998)
  12. "투석길잡이" (2003)[URL]
  13. 화학용어사전편찬회, "화학용어사전" (2011), 일진사
  14. Agarwal, R., "Prevalence, treatment, and control of hypertension in chronic hemodialysis patients in the United States", The American Journal of Medicine, 115(4), pp.291~297 (2003)
  15. Arramreddy, R., "Individualized reduction in dialysate sodium in conventional in-center hemodialysis", Hemodialysis International, 16(4), pp.473~480 (2012)
  16. Chazot, C., "Interdialysis blood pressure control by long haemodialysis sessions", Nephrology Dialysis Transplantation, 10(6), pp.831~837 (1995)
  17. Daugirdas, J. T., "최신 투석 매뉴얼" (2006), 군자출판사
  18. De Paula, F. M., "Clinical consequences of an individualized dialysate sodium prescription in hemodialysis patients", Kidney International, 66(3), pp.1232~1238 (2004)
  19. Flanigan, M., "Dialysate composition and hemodialysis hypertension", Seminnars in Dialysis, 17(4), pp.279~283 (2004)
  20. He, F. J., "Plasma sodium: Ignored and underestimated", Hypertension, 45(1), pp.98~102 (2005)
  21. Keen M. L., "The association of the sodium"setpoint"to interdialytic weight gain and blood pressure in hemodialysis patients", The International Journal of Artificial Organs, 30(11), pp.971~979 (2007)
  22. Keen, M., "Plasma sodium(CpNa)"set point" : Relationship to interdialytic weight gain(IWG)and mean arterial pressure(MAP)in hemodialysis patients(HDP)", Journal of the American Society of Nephrol, 8, pp.241A~ (1997)
  23. Levin, A., "The benefits and side effects of ramped hypertonic sodium dialysis", American Society of Nephrology, 7(2), pp.242~246 (1996)
  24. National Kidney Foundation., "K", DOQI clinical practice guidelines for cardiovascular disease in dialysis patients, 2005, pp.45(4 Suppl 3), S1~153
  25. Penne, E. L., "Sodium Gradient: A tool to individualize dialysate sodium prescription in chronic hemodialysis patients?", Blood Purification, 31(1-3), pp.86~91 (2011)
  26. Sadowski, R. H., "Sodium modeling ameliorates intradialytic and interdialytic symptoms in young hemodialysis patients", Journal of the American Society of Nephrology, 4(5), pp.1192~1198 (1993)
  27. Santos, S. F., "Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients", Clinical Journal of the American Society of Nephrology, 3(2), pp.522~530 (2008)
  28. Tozawa, M., "Pulse pressure and risk of total mortality and cardiovascular events in patients on chronic hemodialysis", Kidney International, 61(2), pp.717~726 (2002)

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