Studies on dialysate asmotic pressure for asymptomatic hemodialysis

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In order to corroborate the appropriate osmotic pressure of dialysate for performing asymptomatic hemodialysis to many patients simultaneously, hemodialysis was performed in 14 cases of long term hemodialysis by using dialysates of high or low osmotic pressure. Methods used were (I); dialysate osmotic pressure undergoes grade down once a day (303→293 mOsm, Na: 143→138mEq/l), (II): it undergoes grade down in three steps a week (313→303→293 mOsm, Na: 148→143→138mEq/l), (III); dialysate osmotic pressure is maintained at 313 mOsm, Na: 148mEq/l, and (IV); it is maintained at 323mOsm, Na: 153mEq/l. By thesefour methods the patients had been treated for 2 or 3 months, the subjective symptoms, body weight, weight, blood pressure, and Na and K in the erythrocytes being examined. The methods, (III) and (IV), were effective to patients with hypotension and with advanced ages. However, as side effects hypernatremia and remarkable thirst were noted about one month after starting the treatment.Simultaneous dialysis for many patients was satisfactorily performed with few side effects and capable of asymptomatic hemodialysis, when the dialysate osmotic pressure wan 303-313 mOsm, Na: 143-148mEq/l. High osmotic pressure of the dialysate was beneficial to some cases, so that the authors are now under devising a method for performing dialysis with subjects orally being given water.
社団法人日本透析医学会の論文