استفاده از محلول همودياليز با پتاسيم 3 در مقابل اميلي اكي والان در ليتر باعث افزايش كفايت دياليز مي شود

Higher dialysis adequacy with 3 mEq/lit versus 1 mEq/lit potassium hemodyalysis solution

Routinely hemodialysis (HD) solution with a K+ concentration of 1 mEq/lit is being used in lranian HD centers. This dialysate K4 concentration may cause dangerous hypokalemia during HD session, and other K+ concentrations of HD solutions are not available. In two previous studies, the effects of different K+ concentrations on dialysis efficacy were studied, which had conflicting results. So we studied the effect of one and three mEgllit K+ concentrations of HD solutions on dialysis efficacy and serum K+ level at the end and 30 minutes after HD session. Thirty chronic stable HD patients contributed in a double blind crossover study. Patients in the first session of two consecutive weeks were hemodialysed with 1 and 3 mEgllit K+ dialysate. At 30 seconds after HD, dangerous hypokalemia ([K+]<3.5 mEgllit) occurred more frequently with dialysate K+ concentration of 1 versus 3 mEq/lit (50% vs. 3.3%, P<0.05). This difference was abolished 30 minutes after completion of HD. Incidences rate of dangerous hyperkalemia ([K+]>5.5 mEq/lit) was similar with both K+ concentrations. Thirty minutes after completion of HD, better HD adequacy was achieved with 3 mEq/lit compared with 1 mEgllit K+ dialysate concentration measured with Kt/V (0.93+0.3 vs. 0.84+0.34, P<0.05) and urea reduction ratio (0.52+0.12 vs. 0.48+0.17, P<0.05). Therefore using 3 mEq/lit K+ dialysate concentration is safer and causes a higher dialysis efficacy compared with I mEq/lit K+ dialysate concentration.