Intradialytic hypotension (IDH) is a most frequent complication of hemodialysis (HD) and may contribute to cardiovascular events and high mortality. The etiology of IDH is multifactorial; therefore, it remains a challenging problem in the management of HD patients. Because moxibustion (MO) at specific points can influences hemodynamics, we hypothesize that Tianjiu (auto-MO) at the traditionally used meridian points will reduce the severity of hypotension in patients who undergo HD.
In this clinical trial, 45 patients had IDH were divided randomly into two (auto-MO therapy and control) groups for 4 weeks. In the Tianjiu (auto-MO) group, the patients were applied at 3 points (Conception Vessel 4, and Kidney 1) for 3-4 h during HD sessions. All number of episodes complicated by symptomatic IDH during HD sessions and the number of IDH-related nursing interventions (Trendelenburg position, manual reduction of ultrafiltration rate, infusion of isotonic saline or hypertonic fluid, lowering of dialysate temperature) in a session were recorded. Pre- and post-dialysis systolic and diastolic BP, pre- and post-dialysis body weights, interdialytic weight gain, percentage of target ultrafiltration achieved, patient's subjective assessment of the degree of fatigue after dialysis (scale from 0 to 10; 0, not at all, 10, extremely) and recovery time from fatigue after dialysis were measured at the 0, 2nd, 4th and 6th week.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
45
After randomization, patients in Tianjiu and placebo (non-Tianjiu) groups will receive 12 sessions of treatment over a 4-week treatment period.The format of the Tianjiu intervention will be the same as in the treatment group. Participants will be instructed to lie supine before their HD session, and then the bilateral KI1 and CV4
The format of the placebo (clay) intervention will be the same as in the treatment group.
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung City, Taiwan
RECRUITINGThe % of target ultrafiltration achieved
The actual ultrafiltration volume divided by the target ultrafiltration volume
Time frame: 1 year
The frequency of IDH episodes and number of nursing interventions during HD sessions
The number of IDH record and related nursing intervention during each H/D session
Time frame: 1 year
patient's participative assessment of the degree of fatigue after dialysis (scale from 0-10)
The improvement of subjective symptom
Time frame: 1 year
Patients' recovery time from fatigue after dialysis
Recovery time is recorded within minutes, when arriving home, at bed time, the next morning, by next HD
Time frame: 1 year
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