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Previous issue date: 2009-03-03 / Introduction: The most frequent adverse events during dialysis are hypotension (20% to 30%) and muscle cramps (5% to 10%), and the most often prescribed treatment to these adverse events is the use of variable sodium (VNa) profiling. Objectives: The aim of the current study was to compare the frequency of adverse events during hemodialysis (HD), interdialytic weight gain, and blood pressure before and after dialysis, with and without the use of VNa, as well as with the use of two variable sodium models: stepwise (VNass) and linear (VNal). Methods: a randomized, cross-over, prospective study that enrolled 22 patients in two groups: one to receive VNas for 12 HD sessions, and the other VNal, for a similar period after 12 sessions without VNa. After a wash-out period of 12 sessions, groups were crossed over. The following parameters were analyzed: adverse events, interdialytic weight gain, and blood pressure (BP) before and after dialysis. Results: Mean age was 61.2?15.2 years; 11 (50%) patients were male. The occurrence of adverse events was significantly different between the period without VNa (48.5%) and those with VNas and VNal (33.7% and 36%; p<0.001). There were no significant differences in BP or interdialytic weight gain among treatment modalities. Conclusion: The use of VNa was associated with a reduction in the number of adverse events. VNas resulted in less episodes of symptomatic hypotension; while VNal may be associated with reduced muscle cramps. VNa modeling is beneficial for selected patients, and should be individually prescribed. / Introdu??o: Os eventos adversos que ocorrem com mais freq??ncia no per?odo transdi?lise s?o hipotens?o (20% a 30%) e c?imbras (5% a 10%), e entre as condutas mais indicadas para o tratamento destas complica??es est? a utiliza??o de s?dio vari?vel (NaV). Objetivos: comparar a ocorr?ncia de eventos adversos em hemodi?lise (HD), o aumento de peso interdial?tico e a press?o arterial pr? e p?s-di?lise, sem e com a utiliza??o de NaV e comparar a ocorr?ncia de eventos adversos em HD com a utiliza??o de duas modalidades de s?dio vari?vel: step (NaVs) e linear (NaVl). M?todo: estudo prospectivo, randomizado e com cross-over que incluiu 22 pacientes para dois grupos: um para tratamento com NaVs durante 12 sess?es de HD e outro para tratamento com NaVl durante o mesmo per?odo, precedidos por 12 sess?es sem NaV. Ap?s per?odo de wash-out, ocorreu o cross-over entre os grupos. Analisaram-se: ocorr?ncia de eventos adversos, ganho de peso interdi?lise e press?o arterial (PA), antes e ap?s o procedimento. Resultados: a m?dia de idade foi de 61,2?15,2 anos e 11(50%) eram do sexo masculino. A ocorr?ncia de eventos adversos foi significativamente diferente entre os per?odos sem a utiliza??o de NaV (48,5%) e com a utiliza??o de NaVs e NaVl, (33,7% e 36%, respectivamente; p<0,001). N?o houve diferen?a significativa de PA entre qualquer das modalidades de tratamento usadas; o mesmo ocorreu com o ganho de peso interdial?tico. Conclus?es: a utiliza??o de NaV reduz a ocorr?ncia de eventos adversos em HD. H? menos hipotens?o sintom?tica com NaVs e tend?ncia para redu??o de c?imbras com o uso de NaVl.. NaV pode ser ben?fico para alguns pacientes e sua prescri??o deve ser individualizada.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1777 |
| Date | 03 March 2009 |
| Creators | Meira, Fernanda Salazar |
| Contributors | D'avila, Domingos Otavio Lorenzoni |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 600, -8624664729441623247 |
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