کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5685874 | 1598235 | 2016 | 8 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Intensive Hemodialysis and Treatment Complications and Tolerability
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کلمات کلیدی
Ultrafiltration - اولترافیلتراسیونchronic kidney disease - بیماری مزمن کلیویFatigue - خستگیHome dialysis - دیالیز اصلیDaily dialysis - دیالیز روزانهrecovery time - زمان بازیابیFrequent Hemodialysis Network - شبکه همودیالیز مکررComplications - عوارض جانبیintradialytic hypotension - فشار خون داخل بینیend stage renal disease (ESRD) - مرحله نهایی بیماری کلیوی (ESRD)Review - مرورshort daily hemodialysis - همودیالیز روزانه کوتاهnocturnal hemodialysis - همودیالیز شبانهIntensive hemodialysis - همودیالیز شدیدDialysis adequacy - کفایت دیالیز
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیماریهای کلیوی
پیش نمایش صفحه اول مقاله

چکیده انگلیسی
Hemodialysis (HD) treatment can be difficult to tolerate. Common complications are intradialytic hypotension (IDH) and long time to recovery after an HD session. IDH, as defined by nadir systolic blood pressure < 90 mm Hg and intradialytic decline > 30 mm Hg, occurs in almost 8% of HD sessions. IDH may be caused by aggressive ultrafiltration in response to interdialytic weight gain, can lead to myocardial stunning and cardiac arrhythmias, and is associated with increased risk for death. Long recovery time after a treatment session is also common. In DOPPS (Dialysis Outcomes and Practice Patterns Study), recovery time was 2 to 6 hours for 41% of HD patients and longer than 6 hours for 27%; recovery time was linearly associated with increased risks for death and hospitalization. Importantly, both decreases in blood pressure and feeling washed out or drained have been identified by patients as more important outcomes than death or hospitalization. Intensive HD likely reduces the likelihood of IDH. In the Frequent Hemodialysis Network trial, short daily and nocturnal schedules reduced the per-session probability of IDH by 20% and 68%, respectively, relative to 3 sessions per week. Due to lower ultrafiltration volume and/or rate, intensive HD may reduce intradialytic blood pressure variability. In a cross-sectional study, short daily and nocturnal schedules were associated with slower ultrafiltration and less dialysis-induced myocardial stunning than 3 sessions per week. In FREEDOM (Following Rehabilitation, Economics, and Everyday-Dialysis Outcome Measurements), a prospective cohort study of short daily HD, recovery time was reduced after 12 months from 8 hours to 1 hour, according to per-protocol analysis. Recovery time after nocturnal HD may be minutes. In conclusion, intensive HD can improve the tolerability of HD treatment by reducing the risk for IDH and decreasing recovery time after HD. These changes may improve the patient centeredness of end-stage renal disease care.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: American Journal of Kidney Diseases - Volume 68, Issue 5, Supplement 1, November 2016, Pages S43-S50
Journal: American Journal of Kidney Diseases - Volume 68, Issue 5, Supplement 1, November 2016, Pages S43-S50
نویسندگان
Jose A. MD, Richard J. MA (Cantab), MBBS, Eric D. PhD, MS, Sheru MD, Peter A. MD, MPH, Paul MD,