Outcome of Hemodialysis Treatment on 200 Cases of Chronic Renal Failure

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval.

The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained;

1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis.

2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%).

The predominant complications were congestive heart failure, pericarditis, and infections.

3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment.

4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis.

5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions.

6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents.

7. Economic problems were the major cause of dialysis interruption.