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Kartläggning av klinisk praxis gällande ultrafiltrationshastighet under hemodialysbehandling
University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
2013 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Syftet var att kartlägga klinisk praxis gällande ultrafiltrationshastighet (UFR) under hemodialysbehandling samt beskriva i vilken omfattning rekommenderad ultrafiltrationshastighet överskrids. Vidare var syftet att beskriva skillnader i UFR mellan män och kvinnor samt mellan patienter som har haft dialys kortare eller längre tid än 18 månader. Föreliggande studie utgick från DOPPS rekommendation där UFR inte bör överstiga 10 ml/h/kgkroppsvikt. Att överstiga rekommenderad UFR har enligt tidigare forskning visat en ökad risk för patienten genom högre morbiditet och mortalitet. Designen som användes var en beskrivande tvärsnittsstudie. Genom lottdragning ur SvensktNjurregister (SNR) gjordes ett slumpmässigt urval av 15 hemodialyskliniker av 66 möjliga. Samtliga hemodialysbehandlingar där ultrafiltration tillämpades vid dessa kliniker på en förvald dag inkluderades i studien. Tio kliniker valde att delta i studien och 167 dialysobservationslistor utgjorde undersökningsgruppen. Utifrån de registrerade studievariablerna, ultrafiltrationsvolym (ml),dialystid (h) och torrvikt (kg), beräknades ultrafiltrationshastighet.Resultatet visade att den vanligast förekommande ultrafiltrationshastigheten var 9.4 ml/h/kg, det vill säga strax under den rekommenderade. Studien visade också att vid var femte hemodialysbehandling överskreds rekommenderad UFR med ökad risk för behandlingsrelaterade komplikationer. Konklusionen i denna studie påvisar att det finns brister i klinisk praxis om riskerna med för hög UFR samtatt rutiner för vad som är maximal UFR saknas.

Abstract [en]

The aim was to identify clinical practices regarding ultrafiltration rate (UFR) on hemodialysis, and describe the extent to which the recommended ultrafiltration rate is exceeded. A further aim was to describe differences in the UFR between men and women and between patients who had dialysis shorter or longer than 18 months. The present study was based on DOPPS recommendation that UFR should not exceed 10ml/h/kg body weight. Prior research has shown an increased risk of the patient when recommended UFR  is exeeded through higher morbidity and mortality. The design used was a descriptive cross-sectional study. By drawing lots from Swedish Renal Registry (SNR), a random sample of 15 hemodialysis clinics of 66 possible. All hemodialysistreatments where ultrafiltration was applied at these clinics on a preselected day were included in the study. Ten clinics chose to participate in the study and 167 dialysis observation lists constituted the study group. Based on the recorded study variables, ultrafiltration volume (ml), dialysis (h) and dryweight (kg) was calculated ultrafiltration rate. The result showed that the most abundant ultrafiltration rate was 9.4 ml/h/kg, that is, just below the recommended. The study also showed that every fifth hemodialysis exceeded recommended UFR with increased risk of treatment-related complications. The conclusion of this study indicate that there are deficiencies in clinical practice about the risks of excessive UFR and the procedures for what is maximum UFR missing.

Place, publisher, year, edition, pages
2013. , 23 p.
Keyword [sv]
hemodialys, njurmedicinsk omvårdnad, ultrafiltrationshastighet
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-15073Archive number: FK - C Vk13-04OAI: oai:DiVA.org:hig-15073DiVA: diva2:643086
Subject / course
Nursing science
Uppsok
Medicine
Supervisors
Examiners
Available from: 2013-08-30 Created: 2013-08-26 Last updated: 2013-08-30Bibliographically approved

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