Complications during hemodialysis in chronic hemodialysis patients using dialysis buffer solution with sodium acetate and sodium bicarbonate

The mortality resulted from complications of hemodialysis has been a great problem throughout the time. Some studies have shown the relation between dialysis buffer solution and the complications. Since such complications have been experienced in Birjand Hemodialysis Center as well, the current study was carried out to determine the relationship of complications during dialysis and the buffer solution used: sodium acetate or sodium carbonate. This descriptive-analytic study was performed on 40 dialysis patients with ESRD who were selected by census method in hemodialysis section of Vali-Asr Hospital, Birjand. They were divided randomly into 2 groups: Group A (under dialysis with sodium acetate) and group B (under dialysis sodium bicarbonate). They were also assessed clinically in terms of complications before, during and after dialysis. Data were analyzed by SPSS and Chi square test. (P<0.05) The majority of patients were in the age category of 56-65 years and female.50%of them had a history of dialysis for less than 6 months as three sessions a week under dialysis. The main causes for dialysis for majority of patients are diabetes (18%) and unknown causes (12%) respectively. The average systolic blood pressure of the patients before, during and after dialysis were 13.2±2.15, 13.85±2.71 and12.61±2.75cm Hg respectively. Associated diastolic pressures were 7.02±1.23, 7.5±1.29 and 7.6±1.67. There was no statistically significant relationship between the type of the solution used and the decrease of diastolic and systolic blood pressure. No (muscle) cramps occurred but the headache (10%), nausea and vomiting (7.5%), hypoxia (22.5%) and chest pain (12.5%) occurrence were not significantly related to the type of the solutions. A decrease in blood pressure by getting to the end of each dialysis session scaled up, proposing the effects of other factors in addition to the type of the solution. Therefore we recommend replacing Acetate by Bicarbonate solutions, if possible, then try to control other factors.