关键词: 血液透析, 饮食, 低血糖, 低血压, 护理

Abstract:

Objective To evaluate the effect of different feeding time during hemodialysis using glucose-free dialysate on the blood glucose and blood pressure in non-diabetes patients. Methods A randomized crossover study was conducted. 40 patients were randomized to 2 groups：the first group taking food at 1.5 hour during hemodialysis for 6 sessions and then taking at 2.5 hour during hemodialysis for 6 sessions;the second group taking food at 2.5 hour during hemodialysis for 6 sessions and then taking at 1.5 hour during hemodialysis for 6 sessions. The blood glucose and blood pressure per hour during hemodialysis were measured. The incidence of hypotension and hypoglycemia at different time points were compared between the 1.5-hour feeding and the 2.5-hour feeding. Results 39 patients were finally included,and glucose and blood pressure were all measured 234 times at each 5 time points（before hemodialysis,1 h,2 h,3 h and 4 h during hemodialysis） in 2 groups. Compared with the 2.5-hour feeding,the incidence of 2 h during hypoglycemia in the 1.5-hour feeding was significantly lower（ χ ²=17.641,P<0.001）. There was no statistical difference in the incidence of hypotension,average systolic blood pressure,average diastolic blood pressure,and pulse pressure difference between 1.5-hour feeding and 2.5-hour feeding during the whole course of dialysis（P>0.05）. The results of repeated measures analysis of variance showed that the levels of blood glucose were significantly higher at 2 h and 3 h in the 1.5-hour feeding than those in the 2.5-hour feeding（P<0.05）. Conclusion Compared to feeding at 2.5 hours,feeding at 1.5 hours can reduce the incidence of intradialytic hypoglycemia,but it did not increase the incidence of intradialytic hypotension in non-diabetic patients using sugar-free dialysate.

Key words: Hemodialysis, Dietary, Hypoglycemia, Hypotension, Nursing Care