How to increase dialysis adequacy; A randomized clinical trial

Abstract

Introduction: Studies have shown when hemodialysis treatment is sufficiently effective, complications of uremic syndrome, additional treatment costs and hospitalization length are reduced. Several methods have been proposed to improve hemodialysis adequacy. Objectives: In this study, the effects of the synchronic use of the stepwise profile dialysis fluid flow rate with increased blood flow rate (BFR) were studied on hemodialysis adequacy. Patients and Methods: This is a cross-over clinical trial study conducted on 34 hemodialysis patients selected from a hemodialysis center of Qazvin University of Medical Sciences, Qazvin, Iran. The patients were randomly allocated into two groups (n= 17 patients in each group) in two sequences. In the first sequence, the subjects received four routine hemodialysis sessions in group one and four hemodialysis sessions with the stepwise profile of the fluid flow rate with increased BFR in group two. In the second sequence, the treatment methods were exchanged. Hemodialysis sessions were performed in both sequences, consecutively. Each session was at least three hours. Hemodialysis adequacy was measured using Kt/V software on the hemodialysis machines after each session. Results: The mean score of dialysis adequacy was 0.89 in the routine method and 1.26 in the profile with increased BFR. There was a statistically significant difference between the methods (t= -7.9, df = 33, P < 0.001). Conclusion: The results of the study suggest that the stepwise profile of the dialysis fluid flow rate with increased BFR should be used synchronously to improve hemodialysis adequacy.

Evaluating the effect of intradialytic exercise on blood pressure, inflammatory markers and dialysis adequacy

“…Increased dialysis adequacy was not significant in both the control and intervention group which was in accord with the results of the study by Dashti et al studies (38). They stated that conducting regular intra-dialytic exercise results in increasing physical performance and reduces muscle atrophy, while it has no significant effect on dialysis quality (38).…”

Predictors of Happiness Among Hemodialysis Patients

“…Hemodialysis patients experience a variety of physical and psychological challenges on a daily basis. Dialysis adequacy is an important and effective factor in reducing or modifying these problems (20). Hemodialysis adequacy is one of the signi cant criteria to evaluate patients undergoing hemodialysis, and achieving high adequacy is one of the signi cant goals in dialysis wards (21).…”

“…One of the main causes of mortality in hemodialysis patients is dialysis inadequacy (23). Its common consequences including poor nutrition, nausea and vomiting, anorexia, headache, depression and insomnia and high levels of stress severely affect the patient's quality of life (20). In such circumstances, serious psychological consequences of the disease and treatment can be prevented by improving the hemodialysis adequacy along with improving the complications of uremia and its effects on other organs (24).…”