Curative effectiveness of high frequency ultrafiltration for renal edema with diuretic resistance
Curative effectiveness of high frequency ultrafiltration for renal edema with diuretic resistance
Blog Article
Objective To study the clinical curative effectiveness of high frequency ultrafiltration for the renal edema with diuretic resistance.Methods We selected 42 cases of nephrotic syndrome with severe edema.Among them,there were 20 cases of diabetic kidney disease,10 cases of lupus nephritis,8 cases of refractory primary nephrotic syndrome,and 4 cases of multiple myeloma nephropathy.All patients were 9x11 pergola subjected to standard treatment for 3-5 days according to different primary diseases after admission.
Their urine was less than 800 mL every day and it met the standard of diuretic resistance.Then the patients were treated with ultrafiltration.The scheme of ultrafiltration treatment was as follows:blood flow rate was 160-180 ml/min,dialysate flow rate was 500 ml/min,dehydrated level was 1 500-3 000 mL every time mainly in the single ultrafiltration period,ultrafiltration rate less than 800 ml/h,once every day,4.0-5.
0 h every time;after continuous treatment for 5-7 days,1-3times every week.Treatment plan above was trimmed for the patients with high blood pressure,severer heart failure symptoms or hypotension tendency.Primary diseases were treated actively and necessary nutritional support was given during ultrafiltration,and diuretic was withdrawn.Daily urine volume,edema severity score,dyspnea score,serum creatinine(SCr),plasma albumin(Alb),N terminal B type natriuretic peptideprecursor(NT-proBNP),arterial blood gas,24-h urine protein were observed and compared before and after treatment.
Results The edema scores,daily urine volume,dyspnea score,SCr and NT-proBNP showed significant difference before and 1,2,3 weeks after treatment(P0.05).Blood gas analysis(potassium,sodium,bicarbonate and base excess) showed significant difference before and 1,2,3 weeks emtek 2113 after treatment(P0.05).
Conclusions The short-term curative effectiveness of high frequency ultrafiltration for the renal edema with diuretic resistance is significant,and high frequency ultrafiltration can effectively improve the diuretic resistance,which may win a guarantee of time and space for primary disease treatment.