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HEMODİYALİZ HİPOTANSİYONUNDA FARKLI SODYUM VE ULTRAFİLTRASYON PROFİLİNİN ETKİNLİĞİ

EFFECTMTY OF DIFFERENT SODIUM AND ULTRAFILTRATION PROFILES ON HEMODIALYSIS-INDUCED HYPOTENSION

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Abstract (2. Language): 
Dialysate sodium (Na) and ultrafitration (UF) profiling are two methods to reduce dialysis-induced hypotension. The aim of this study was to determine the efficacy of combining these techniques to reduce dialysis-induced hypotension in chronic hemodialysis (HD) patients. In our hemodialysis center there were 69 patients. Initially standard dialysis with constant dialysate sodium and ultrafiltration protocol were used in all patients. In nineteen patients (27%) dialysis-induced hypotension was established.Their ages were 48.53±16.92 years. (14 female and 5 male). Their dialysis duration were 36.00±40.45months.In these patients; six different sodium and ultrafiltration profiling were used to prevent dialysis-induced hypotension. In ten (52.6%) patients sodium and ultrafiltration profiling (I) were used and dialysis-induced hypotension was prevented. In five (15.7%) patients sodium and ultrafiltration profiling (V) were used and dialysis-induced hypotension was prevented. In two (10.4%) patients sodium and ultrafiltration profiling (IV)7 were used and dialysis-induced hypotension was prevented. In one (5.2%) patient sodium and ultrafitration profiling (111) were used and dialysis induced hypotension was prevented. In three (15.7%) patients different sodium and ultrafitration profiles were used, but dialysis-induced hypotension could not be prevented. In conclusion, we demonstrated that combined dialysate sodium concentration and ultrafitration profiling significantly reduce dialysis-induced hypotension comparing to standard dialysis with constant dialysate sodium and ultrafiltration. We recommend that Na and UFprofiles should be used routinely in hemodialysis practice.
Abstract (Original Language): 
Diyalizat sodyum ve ultrafiltrasyon (UF profili diyaliz hipotansiyonunu azaltmada kullanılan metodlardandır. Bu çalışmanın amacı kronik hemodiyalizde diyaliz hipotansiyonunu azaltmak için bu tekniklerin kombine kullanımının etkinliğini değerlendirmektir. Hemodiyaliz merkezimizde kronik hemodiyalize girmekte olan 69 hasta (36 K, 33 E) çalışmaya alındı. Başlangıçta, tüm hastalarda standart diyaliz protokolü uygulandı. Diyaliz hipotansiyonu 19 hastada (%27) saptandı. Bu hastalarda, diyaliz hipotansiyonunu önlemek için sırasıyla 6 farklı sodyum ve UF profili uygulandı. Sodyum ve UFprofilIile çalışmaya başlandı. Şayet profil Iile ardışık 10 hemodiyaliz seansı boyunca hipotansiyon gelişmezse aynı profil ile devam edildi. Hipotansiyon gelişen hastalarda ise sırasıyla diğer profil tiplerine geçildi. Hipotansiyon gelişen 19 hastadan 10'unda (%52.6) sodyum ve UF profili I uygulanması ile diyaliz hipotansiyonu önlendi. Sodyum ve UF profili V ile 5 hastada (%15.7), sodyum ve UF profili IV ile 2 hastada (%10.4), sodyum ve UF profili III ile 1 hastada (%5.2) diyaliz hipotansiyonu önlendi. Ama 3 hastada ise sodyum ve UF profili kullanımına rağmen diyaliz hipotansiyonu önlenemedi. Kombine diyalizat sodyum ve UF profili kullanımı ile standart diyaliz protokolü ile karşılaştırıldığında diyaliz hipotansiyonunda anlamlı azalma gösterilmiştir. Hemodiyaliz pratiğinde sodyum ve UF profili kullanılmalıdır.
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