Cross-sectional Survey of Volume Management in Peri-dialysis Patients in a Single Center

Abstract

Objective: To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period (peri-dialysis period) by investigating the current situation of volume management of such patients in our hospital, to reduce the incidence of volume overload during this period. Methods: A total of 86 patients in the peri-dialysis period (glomerular filtration rate eGFR less than 15 mL/(min·1.73 m²) to three months after dialysis) who received outpatient treatment, inpatient treatment, and hemodialysis in the hospital from June 2022 to December 2023 were selected as the research objects. General information, clinical symptoms, and laboratory data of the patients were collected. According to the disease evolution process of the patients, they were divided into the non-dialysis stage and the initial dialysis stage. The volume load index of the patients, namely the overhydration (OH) value, was measured by the multi-frequency bioelectrical impedance method. The relevant factors affecting the volume load of patients in the peri-dialysis period were compared and analyzed. Results: In the non-dialysis stage, 68 patients (86%) had volume overload, and 21 patients (21%) had normal volume load. In the initial dialysis stage, 53 patients (61%) had volume overload, and 33 patients (38%) had normal volume load. Among the patients with volume overload in the two stages combined, the primary diseases were diabetic nephropathy at 29%, hypertensive nephropathy at 29%, primary nephropathy at 34%, and other renal damage at 8%. Complications included heart failure at 29%, respiratory tract infection at 32%, coronary heart disease at 9%, and anemia at 21%. Among the patients with volume overload, 69% were male, 52% were over 60 years old, 53% had no family member accompaniment, 57% had insomnia, and 55% had an educational level of junior high school or below. Conclusion: More than half of the patients in the peri-dialysis period in the hospital are in a state of volume overload, which should arouse the attention of the department. For male patients, those with hypertension, diabetes, insomnia, respiratory tract infection, anemia, and without family member accompaniment, corresponding intervention measures should be taken to reduce the incidence of volume overload during the peri-dialysis period.