Study on the effectiveness and safety of artificial intermittent infusion hemodiafiltration in MHD patients with intradialytic hypotension

Objective: To evaluate the effectiveness and safety of artificial intermittent infusion hemodiafiltration (I-HDF) in maintenance hemodialysis (MHD) patients with intradialytic hypotension (IDH), and to determine the optimal infusion dosage.

Methods: This single-center, prospective, self-controlled study included 30 MHD patients with IDH, treated from December 2022 to July 2023. Patients underwent three sessions of I-HDF as treatment group and conventional hemodialysis as control group. Comparisons were made between the two groups regarding changes in blood pressure, hypotension symptoms, changes in body water content, and achievement of infusion doses.

Results: 1. The fluctuation amplitude of SBP in the treatment group was 18.96 ± 10.400, while in the control group it was 27.4 ± 11.796. There was a significant difference between the two groups (p < 0.05). 2. During 90 sessions of dialysis, 39 interventions were needed in the treatment group, compared to 59 interventions in the control group. The treatment group required fewer interventions, with a significant difference (p < 0.05). 3. No hypotension symptoms occurred in the treatment group, whereas six cases were observed in the control group, which was significantly higher (p < 0.05). 4. One patient in the 250 ml infusion group experienced chest tightness. Among the three infusion groups, the 250 ml group had the greatest fluctuation in DBP, with a significant difference (p < 0.05). 5. Among the three infusion volumes groups, there was a significant difference between the theoretical and actual infusion volumes in the 150 and 200 ml groups (p < 0.05).

Conclusion: The artificial I-HDF mode effectively improves the occurrence of IDH. An infusion dose of 150-200 ml is deemed appropriate.