Effect of intermittent normal saline bolus during hemodialysis on adequacy of dialysis

Abstract

Background and purpose: Using practical and non-invasive methods to improve the adequacy of dialysis (i.e. Kt/V) can increase the quality of life and decrease the mortality and morbidity rate in patients under hemodialysis. This study was conducted to investigate the effect of intermittent normal saline bolus on adequacy of dialysis. Materials and methods: In this randomized controlled cross-over clinical trial, 51 patients were chosen based on inclusion criteria and were randomly assigned into two groups. Before the intervention, the Kt/V and Urea Reduction Ratio (URR) of the last session of dialysis (baseline) were measured in all patients. The control group were dialyzed conventionally (heparinized dialysis), but the intervention group received 100 ml normal saline bolus every hour, within three times. In three subsequent sessions, as a washout period, all patients received conventional hemodialysis. Then the patients were swapped and all steps were repeated. Results: Before the intervention, there were no significant differences between the two groups in age, sex, duration of dialysis, type of vascular access, adequacy of dialysis, and Urea Reduction Ratio (P>0.05). Compared with baseline, the Kt/V and URR mean values increased by 16 and 8 in intervention group, respectively (P<0.01) but these values decreased in control group. In addition, findings revealed significant differences in Kt/V and URR mean values between the two groups after using normal saline bolus intermittently (P< 0.01). Conclusion: Using intermittent normal saline bolus during hemodialysis improves adequacy of dialysis. © 2018, Mazandaran University of Medical Sciences. All rights reserved