Abstract:

Object To study the significance of central venous pressure (CVP) for assessing the volume status and guiding the ultrafiltration volume in patients with maintenance hemodialysis (MHD).  Methodology: Thirty five MHD patients with stable general conditions were enrolled this study. Before and after single hemodialysis, the parameters involved CVP, ultrofiltration volume, blood pressure(BP), heart rate(HR) ,the incidences of low blood pressure and muscular twitching, the interdialytic weight gain(IDWG), the morning blood pressure in non-dialysis days, incidence of heart failure, admission rate due to cardio-cerebrovascular diseases, the shifts of cardio-thoracic ratio(CTR) and so on were observed and recorded by a matched pair design with cross-reference. This procedure had taken 6 month, and the former 3 month as a control group without monitoring CVP and the latter 3 month as an observation group with the CVP supervised. Then all the parameters in the two parts were compared.  Results：There were significant differences in incidences of low blood pressure, muscular twitching, inter-dialytic heart failure and the morning blood pressure in non-dialysis days (P<0.05), while the CTR and admission rate due to cardio-cerebrovascular diseases did not significantly differ. In a single hemodialysis, the decline of CVP correlated with the rectified ultrafiltration volume（r=0.598）. When CVP declined 1cmH2O, the rectified ultrafiltration volume was 9.89±3.57. It was significantly lower in diabetic nephropathy (DN) than that in the non-DN patients [(8.26±2.84) vs (11.5±4.08)ml/kg.cmH2O,(P<0.05)]. Conclusion:The corresponding relationship between of CVP and ultrafiltration is helpful to evaluate the volume status in patients with MHD and to decrease the complications with ultrafiltration.