중심정맥 혈관통로를 이용한 혈액투석에서 동 정맥 정상순환과 역순환 방법에 따른 재순환율 및 투석량 비교

Abstract

Hemodialysis has been widely used for chronic renal failure patients as a renal replacement therapy. In the hemodialysis dual lumen catheter can be used temporarily until a arterio-venous fistula becomes mature. It is important to maintain the prescribed blood flow, since it reduces a recirculation rate and gives patients the prescribed hemodialysis doses. Thus, it can decrease the mortality rate and prevalence rate, consequently it improves the qualities of lives. In hemodialysis, a dual lumen catheter is inserted into the central vein, when blood flow passing through the catheter is insufficient. This imposes a lot of physical and emotional burden on patients. Thus, a reverse method, which replaces the artery with a vein is temporarily used. In this study, the recirculation rate and hemodialysis dose(Kt/V) of patients having the reverse method because of insufficient blood flow(defined as less than 250ml/min for 4 hrs in the ordinary method) were investigated. These were compared with those of ordinary hemodialysis patients in order to verify the feasibility of the reverse method. The recirculation rate and Kt/V of 34 patients(17 ordinary hemodialysis patients and 17 patients having the reverse method) were measured. Between April, 17, 2001 and August, 9, 2002. raw data were analyzed by the Mann-Whitney U analysis method(SPSS). The average recirculation rates were 2.32±2.72% for the ordinary hemodialysis patients and 4.51±3.95% for the patients having insufficient blood flow. These results imply that there is no statistically significant difference. The average Kt/V was found to be 1.30±0.19 for ordinary hemodialysis patients and 1.30±0.25 for patients having the reverse method. These results also showed no statistically significant difference. Therefore, it is suggested that the reverse method can be used as long as the blood flow is maintained at 250ml/min.