Abstract: Objective  To observe the efficacy of the sequential therapy of sustained low efficiency dialysis (SLED) and intermittent hemodialysis (IHD) in uremic patients with diabetes mellitus, and to explore better and practical hemodialysis treatment model.  Methods  Uremic patients with diabetes mellitus who were undergoing maintenance hemodialysis for more than 3 months were enrolled in this study. The patients were divided into sequential group (IHD twice a week and SLED once a week) and conventional group (IHD 3 times a week). Blood pressure, blood pressure variability, dialysis dehydration, BNP, Kt/V and urea reduction ratio (URR) were compared between the two groups.  Results  There were 10 patients in the sequential group and 24 patients in the conventional group. Systolic blood pressure (SBP) before dialysis (t=-1.053,     P=0.300), diastolic blood pressure (DBP) before dialysis  (t=-1.020, P=0.315),  SBP at 2 hours of dialysis  (t= -1.861, P=0.072), DBP at 2 hours of dialysis (t=-1.227, P=0.229), SBP after dialysis (t=-1.901, P= 0.066), DBP after dialysis (t=-0.945, P=0.354), systolic blood pressure standard deviation (SBP_SD) between dialysis (t=-1.784, P=0.084), and DBP_SD between dialysis (t=-1.530, P=0.136) showed no statistical significances between the two groups. The variability of systolic blood pressure during follow up period (SBP_SD before dialysis) was significantly lower in the sequential group than in the conventional group (t=-2.166，P=0.038); Kt/V (t=2.878, P=0.007) and URR (t=2.643, P=0.013) were higher in the sequential group than in the conventional group.  Conclusion  Compared with conventional IHD, the sequential therapy of SLED and IHD can better control the blood pressure variation between dialysis, ensure the stability of hemodynamics, and improve the adequacy of dialysis.

Key words: Sustained low efficiency dialysis, Intermittent hemodialysis, Diabetes, Uremia