- Readjustment of Optimal Dry Body Weight is Important in Hemodialysis Patients Transferred between Artificial Kidney Units
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Mun Jang
2020 ; 2020(1):
Optimal DBW | Readjustment
- 논문분류 :
- 춘계학술대회 초록집
Volume expansion is one of the most important factors related to hypertension in hemodialysis (HD) patients. An HD communication sheet is needed when a HD patient is transferred to another artificial kidney (AK) units. The HD communication sheet includes a patient’s dry body weight (DBW), prescribed medications and other information associated with HD. This study demonstrates that optimal DBW on an HD communication sheet is doubtable and re-valuable. We analyzed clinical volume status and antihypertensive drug dosage as determined by a nephrologist in 78 HD patients (male, n=44; mean age, 56.3 years [range 34 - 84]). All patients had been transferred to a new local AK unit. Before being transferred, they had undergone HD in other units for more than 6 months. We selected clinically hypervolemic patients and analyzed blood pressure (BP) and antihypertensive drug dosage. After resolution of hypervolemia, we compared antihypertensive drug dosage before and after adjustment for optimal DBW. Of the 57 patients (73%) experiencing clinical hypervolemia, all were prescribed antihypertensive drugs. Among them, 52 (91%) patients had BP values over 140/90 mmHg before and after HD. After adjustment, DBW of all 57 (100%) patients were reduced by more than 1 kg (2.5 ± 1.2 kg, p < 0.01), and in 51 (89%) patients antihypertensive drug dosage was reduced (p = 0.023). Nevertheless, systolic BP remained under 140 mmHg in 45 (87%) of 52 patients with poorly-controlled BP (before dialysis: 134 ± 7.4 mmHg, p < 0.01, after dialysis: 128 ± 9.2 mmHg, p < 0.01). When HD patients are transferred to another AK unit, readjustment for optimal DBW is fundamental.