Improvement of physical function and QOL of hemodialysis patients by stabilizing autonomic nervous function

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K21521
• Project/Area Number (Other): 18H06451 (2018)
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund (2019); Single-year Grants (2018)
• Review Section: 0909:Sports sciences, physical education, health sciences, and related fields
• Research Institution: Morinomiya University of Medical Sciences
• Principal Investigator: Tsuji Yoshihiro 森ノ宮医療大学, 保健医療学部, 准教授 (20825484)
• Project Period (FY): 2018-08-24 – 2022-03-31
• Keywords: 血液透析 / 除水速度

Outline of Final Research Achievements

The ultrafiltration rate (UFR) is one of the important factors involved in long-term mortality in hemodialysis (HD) patients. Presence of diabetes mellitus often affects UFR due to abrupt hypotension during dialysis. In this study, we aimed to find the optimal UFR to improve the mortality in this population with and without diabetes mellitus (DM). The relationship between the UFR and mortality in patients in the non-DM group and those in the DM group was evaluated. The cutoff UFR values of the non-DM and DM groups were 12.07 ml/hr/kg and 9.66 ml/hr/kg, respectively. Lower UFR is essential for the long-term mortality of HD patients, and optimal UFR would be different between patients with and without DM.

Free Research Field

血液浄化

Academic Significance and Societal Importance of the Research Achievements

本研究では，「透析患者の自律神経機能を安定化させることにより，身体的な機能改善および患者QOLを向上させること」を目的とした．患者ごとに最適な除水速度を決定し血液透析を行うことは必須である．本研究では最適な除水速度を決定するため，透析患者の平均除水速度と死亡率の関係を調べた結果，非糖尿病性腎症患者群と糖尿病性腎症患者の至適UFRはそれぞれ12.07 mL/hr/kgと9.66 mL/hr/kgであった．本研究の結果は，過除水が引き起こす交感神経過活動による致死性不整脈，急激な血圧低下による循環不全，心臓突然死の予防し，患者のQOLの向上，社会復帰の上昇，合併症の予防を可能とする．