英文摘要 |
Purposes: Databases of hemodialysis patients contain some important data and information that have not been investigated yet. The purpose of this study was to investigate the risk factors of dialyzer clotting and replacement. Methods: The subjects were patients who received hemodialysis at a kidney dialysis center and whose blood tubing was replaced as clots were observed in the tubing during dialysis. Data were collected from medical records between February 2016 and March 2018. Multiple logistic regression analysis was performed to determine the factors influencing dialyzer clotting and replacement. Results: A total of 674 patients experienced clotting in the dialysis tubing. The significant independent influencing factors for the occurrence of dialyzer clotting requiring tube replacement were compared. A univariate analysis revealed that dialyzer clotting and replacement were associated with the type of dialyzer, vascular access, platelet count, and anticoagulant maintenance dose. A multiple logistic regression analysis revealed that the type of dialyzer and vascular access were independent risk factors of dialyzer clotting and replacement. Rinsing the tubing with heparin before dialysis and using anticoagulants during and at the beginning of dialysis are protective factors against dialyzer clotting and replacement. Conclusions: The results of this study support the use of wet dialyzers, permanent vascular access, rinsing with heparin before dialysis, and initial and maintenance doses of anticoagulants to prevent dialyzer clotting. (Cheng Ching Medical Journal 2020; 16(3): 37-44) |