Chronic kidney disease stage 5 is a common chronic disease in nephrology. When toxins in the blood cannot be eliminated in a timely manner, patients may need to undergo hemodialysis treatment. During the process of hemodialysis, monitoring and evaluating dry weight play a crucial role in better controlling the progression of the disease and improving treatment outcomes. In this article, we will delve into the significance of dry weight and the importance of monitoring and evaluation, helping everyone better understand and handle the treatment of stage 5 hemodialysis patients with chronic kidney disease.
Firstly, we need to understand what stage 5 chronic kidney disease is. Chronic kidney disease (CKD) refers to a disease in which the function of the kidney is gradually lost. It can be caused by many reasons, such as diabetes, hypertension, glomerulonephritis, polycystic kidney, etc. Chronic kidney disease can be divided into five stages, based on the glomerular filtration rate (GFR). GFR refers to how many milliliters of blood pass through the filtering unit (glomerulus) of the kidneys per minute. The GFR of a normal person is approximately 120 milliliters per minute. When GFR drops below 15 milliliters per minute, it belongs to stage 5 of chronic kidney disease, also known as end-stage renal disease (uremia). At this point, the kidneys are no longer able to effectively clear waste and excess fluids from the body, leading to the accumulation of fluids, electrolytes, and toxins in the body, causing various complications such as anemia, osteoporosis, cardiovascular disease, and neurological damage. If not subjected to manual filtration (dialysis) or kidney transplantation, it may be life-threatening.
At this point, we need to understand what hemodialysis (HD) is. HD is a commonly used treatment method to replace kidney function, which involves extracting blood from the body, exchanging substances and water with dialysate through an artificial dialyzer, and then returning purified blood to the body to remove metabolic waste and excess water. Hemodialysis can effectively improve patients' urinary symptoms, prolong their survival time, and improve their quality of life. However, hemodialysis also has some drawbacks and risks, such as the need for regular hospital treatment, the need to establish stable vascular access, and the possibility of complications such as hypotension, infection, and coagulation.
During the process of hemodialysis, attention should be paid to controlling dry weight, which refers to removing excess water from the blood and effectively controlling the patient's "water supply". If the dry weight is too low, it can lead to problems such as dehydration and electrolyte imbalance. If the dry weight is too high, it can lead to edema and significant weight fluctuations, which can have adverse effects on the kidneys. Dry weight is an important reference for dialysis patients' dehydration, and doctors set the ultrafiltration volume based on dry weight (not exceeding 5% of dry weight); Patients control and monitor their weight gain during dialysis based on dry weight. Insufficient dehydration can cause water retention in the body, leading to hypertension, right ventricular hypertrophy, heart failure, etc. Excessive dehydration can lead to low blood pressure and muscle spasms, as well as rapid loss of residual kidney function.