UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence

被引:30
作者
Dasgupta, Indranil [1 ,2 ]
Farrington, Ken [3 ,4 ]
Davies, Simon J. [5 ]
Davenport, Andrew [6 ]
Mitra, Sandip [7 ]
机构
[1] Birmingham Heartlands Hosp, Birmingham B9 5SS, W Midlands, England
[2] Univ Birmingham, Birmingham B9 5SS, W Midlands, England
[3] E&N Herts NHS Trust, Stevenage, Herts, England
[4] Univ Hertfordshire, Dept Postgrad Med, Hatfield AL10 9AB, Herts, England
[5] Keele Univ, Keele, Staffs, England
[6] Royal Free Hosp, UCL Ctr Nephrol, Pond St, London NW3 2QG, England
[7] Manchester Acad Hlth Sci Ctr, Manchester, Lancs, England
关键词
Bio-impedance; Fluid overload; Haemodialysis; Residual renal function; Volume control; RESIDUAL RENAL-FUNCTION; RANDOMIZED CONTROLLED-TRIAL; INTERDIALYTIC WEIGHT-GAIN; BLOOD-PRESSURE CONTROL; DIALYSIS PATIENTS; INTRADIALYTIC HYPOTENSION; MORTALITY RISK; DRY-WEIGHT; BIOIMPEDANCE; OVERLOAD;
D O I
10.1159/000444246
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. Methods: An online questionnaire was distributed to all UK renal centres. Results: Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance- based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. Conclusion: There is an urgent need for establishing an evidence base on the optimal approaches to fluid management. (C) 2016 S. Karger AG, Basel
引用
收藏
页码:324 / 331
页数:8
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