Clinical Efficacy of Meglumine Adenosine Cyclophosphate Combined with Low Temperature Adjustable Sodium Hemodialysis for Intradialytic Hypotension
1.Department of Nephrology，the Third Affiliated Hospital of Xuzhou Medical University，Xuzhou 221003，China
2.Department of Nephrology，Affiliated Hospital of Xuzhou Medical University，Xuzhou 221006，China
*Corresponding author：FENG Jin-hong，Associate chief physician；E-mail：email@example.com
Abstract：Objective To investigate the clinical efficacy of meglumine adenosine cyclophosphate（MAC） combined with low temperature adjustable sodium hemodialysis（LSHD） for intradialytic hypotension（IDH）．Methods We enrolled 28 patients with recurrent IDH who were admitted to the Blood Purification Center，Affiliated Hospital of Xuzhou Medical University and the Third Affiliated Hospital of Xuzhou Medical University from June to December 2015 and who met the inclusion criteria.All patients underwent either conventional hemodialysis（CHD），LSHD，or MAC combined with LSHD（M-LSHD） three times a week for 8 weeks，respectively.Changes in blood pressure and the incidence of hypotension were recorded during hemodialysis.Electrolyte（K+，Na+，Ca2+），serum urea nitrogen，serum creatinine，and N-terminal pro-brain natriuretic peptide（NT-proBNP） levels were also measured，and adverse effects were observed before and after the final hemodialysis for each treatment.Results There was no significant difference in systolic or diastolic blood pressure prior to hemodialysis among the three treatments（P>0.05）．The lowest systolic and diastolic blood pressures during hemodialysis were significantly greater and the incidence of hypotension was significantly lower in patients undergoing M-LSHD compared with CHD or LSHD（P<0.05）．There were no significant differences in serum K+，Na+，Ca2+，urea nitrogen，or creatinine levels between before and after the final hemodialysis for each treatment（P>0.05），but NT-proBNP levels were significantly lower in patients undergoing M-LSHD compared with the other procedures both before and after hemodialysis（P<0.05）．In addition，no patients showed intolerance to low temperature，such as by chilling or shivering，and no palpitation or dizziness occurred following intravenous injection of MCA.Conclusion M-LSHD may reduce the incidence of IDH by improving cardiac function in hemodialysis patients，with no apparent adverse reactions.These results have important clinical implications.
濮红梅1，冯锦红2*，刘秉成2，徐静1. 环磷腺苷葡胺联合低温可调钠透析治疗透析中低血压的临床疗效研究[J]. 中国全科医学, 2018, 21(15): 1805-1808.
PU Hong-mei1，FENG Jin-hong2*，LIU Bing-cheng2，XU Jing1. Clinical Efficacy of Meglumine Adenosine Cyclophosphate Combined with Low Temperature Adjustable Sodium Hemodialysis for Intradialytic Hypotension . Chinese General Practice, 2018, 21(15): 1805-1808.