比較不同的透析液鈉濃度對透析患者透析間期體重增加與血壓之影響

Comparison of Different Dialysate Sodium Concentration on Interdialytic Weight Gain and Blood Pressure in Hemodialysis Patients

邱宜惠(Yi-Hui Chiu) ； 陳佳玫(Chia-Mei Chen) ； 李筱玲(Hsiao-Ling Lee) ； 陳曉眉(Xiao-Mei Chen) ； 馮英鳳(Ying-Feng Feng) ； 楊其璇(Chi-Hsuan Yang) ； 戴金英(Chin-Ying Dai)

《臺灣腎臟護理學會雜誌》 13卷4期 (2014/12) Pp. 13-23

https://doi.org/10.3966/172674042014121304002

摘要

本研究旨在檢視透析液低、高鈉濃度（dialysate sodium concentration, DSC），對透析患者透析間期體重增加（interdialytic weight gain, IDWG）與血壓的影響。以病歷回顧的方法，收集中部地區三家透析中心血液透析患者之資料，探討透析液鈉濃度與IDWG與血壓之相關性。共收集221人，透析液鈉濃度≦138 mEq/L（低鈉透析組）有29人，≧139 mEq/L（高鈉透析組）有192人，以獨立樣本t檢定二組之IDWG與血壓是否有顯著差異。結果：兩組的IDWG有顯著差異（t=2.14, p=.03），低鈉透析之IDWG為2.03公斤，高鈉透析組之IDWG為2.49公斤，即低鈉透析組的IDWG比高鈉透析組少.46公斤。二組個案透析前收縮壓、舒張壓、平均動脈壓、透析中發生低血壓與抽筋的次數沒有顯著差異。結論顯示透析液低鈉濃度之患者，傾向有較低的IDWG與IDWG%。研究結果可以提供臨床專業人員設定較低的DSC，是控制患者IDWG的方法之一。

關鍵字

透析間期體重增加 ； 血壓 ； 透析液鈉濃度 ； 血液透析

並列摘要

The purpose of this study was to determine the most ideal dialysate sodium concentration (DSC) for interdialytic weight gain (IDWG) and blood pressure in chronic hemodialysis patients. A retrospective, descriptive design was employed to investigate the relationship between the DSC and IDWG and blood pressure. Chart reviews were performed to collect data. A total of 221 clients receiving dialysis at three dialysis centers in central Taiwan were included in the study. These clients were grouped according to DSC into the low DSC group (≦low 138 mEq/L; n = 29) and high DSC group (≧139 mEq/L; n = 192). Independent t-test was used to determine the differences in IDWG and blood pressure between the groups. Significant difference in IDWG was found (t = 2.14, p = .03); patients receiving hemodialysis had less IDWG with a low DSC. However, there was no significant difference in pre-dialysis blood pressures for either systolic blood pressure, diastolic blood pressure, or mean arterial pressure. IDWG could be improved when DSC level was set at ≦138 mEq/L.

並列關鍵字

interdialytic weight gain ； blood pressure ； dialysate sodium concentration ； hemodialysis