Abstract: 【Abstract】 Objective To explore the preventive measures to intradialytic hypotension (IDH) in maintenance hemodialysis patients by comparing the effect of six hemodialysis schemes. Methods The six hemodialysis schemes included linear sodium profile (Na-1) or stepwise sodium profile (Na-2) combined with
one of the three ultrafiltration patterns, i.e, linear ultrafiltration pattern (UF-1), alternative high/low ultrafiltration pattern (UF-2), or stepwise pattern (UF-3). We observed 20 stable hemodialysis patients, who first used the standard dialysis scheme, and then sequentially used one of the six hemodialysis schemes each for 2 weeks. Changes of intradialytic blood pressure, prevalence of IDH, and prevalence of failure to achieve the dry weight during dialysis sessions were analyzed. Results ①In patients in the stage using the six hemodialysis schemes, the intradialytic mean arterial pressure (MAP) at 3 and 4 hours after dialysis increased significantly and the prevalence of IDH was significantly decreased, as compared with those in the stages using the standard dialysis
scheme. ②Hemodialysis schemes 2 (Na-2+UF-1) and 4 (Na-2+ UF-2) improved MAP and reduced IDH rate better than other schemes. ?Hemodialysis schemes 1 and 2 reduced the prevalence of failure to achieve the dry weight remarkably. Conclusions In hemodialysis patients, the stepwise sodium profile (Na-2) combined with the alternative high/low ultrafiltration pattern (UF-2) can reduce the prevalence of IDH with sufficient ultrafiltration volume. Therefore, this dialysis scheme can be used as an effective method to prevent IDH.

Key words: Hemodialysis, Sodium profile, Ultrafiltration profile, Intradialytic hypotension