Korean Journal of Nephrology 2000;19(2):297-303.

원저 : 만성신부전 환자에서의 초기 투석 시작시와 장기 투석 후의 임상적, 실험적 특징의 고찰 (Clinical and Laboratory Features of Patients with Chronic Renal Disease at the Start and After the Chronic Maintenance Hemodialysis)

김호중(Ho Jung Kim),박일규(Ile Kyu Park),한상웅(Sang Woong Han),양성규(Seong Kyu Yang),유준호

Abstract

Objective: We examined clinical and laoratory features retrospectively in 56 patients at the start and after the chronic maintenance hemodialysis in order to provide a more complete picture of the uremic symdrome" in the dialysis era. for deciding the time when chronic hemodialysis must be started. Methods: The records of 56 patients began chro-nic hemodialysis treatment at the Han Yang University Hospital from 1995 august until 1997 august were reviewed retrospectively. The information gathered in-cluded demographic data, renal diagnosis, uremic symptoms, biochemical values. Results: The most prevalence of manifestation of uremia was general weakness(67.9%). Unexpected fin-dings were the wide ranges of serum creatinine levels(3.5 to 19.4mg/dL) and blood urea nitrogen levels (19 to 204mg/dL), creatinine clearance rate(1.2-17.4mL/ min), and the frequency of hyponatremia(19.6%), hypo-albuminemia(69.6%), and the anion gap above 14mByL was(66.7%). There was higher potassium leve1 in dia-betes mellitus patients than non-diabetes mellitus pa-tients(6.2±1.6mEq/L VS. 4.9±1.0mEq/L,p=01). Patients laboratory values were changed after the chronic main- tenance hemodialysis-Albumin(3.2±0.8 to 3.6±0.5gm/dL, p=0.01), calcium(7.6±1.2 to 8.7±1.9mg/dL, p=0.01), he-matocrit(23.0±4.7 to 27.7±4.2% , p=0.01), phosphorus (5.6±2.1 to 4,6±1.4mg/dL, p=0.01), pH(7.30±0,1 to 7.35±0.2, p>0.05), anion gap(22,0±11.0 to 12.1±8.8mg/dL, p>0.05). Conclusion: Finally, uremic symptoms were ex-pressed mainly gastro-intestinal and respiratory sym-ptoms. Chronic renal failure associated with diabetes mellitus was earlier on set of uremic symptoms and higher level of serum potassium level than other underlying diseases. Uremic symptoms and laboratory values were almost corrected but metabolic acidosis was not corrected significantly after the chronic main- tenance hemodialysis.