---

Background & Aim: Hemodialysis is a common replacement therapy for patients with ESRD, worldwide. Effective and adequate hemodialysis can improve quality of life and reduce complications of renal failure. Enhancing quality of dialysis results in reducing the complications and mortality rate in patients with chronic renal failure. The aim of this study was to assess the adequacy of dialysis in patients undergoing dialysis with Bicarbonate solution in hemodialysis ward of a hospital in Sary.

Methods & Materials: This cross-sectional study was conducted on 50 patients admitted in the hemodialysis ward with chronic renal failure diagnosis. A researcher-made questionnaire was used to gather data. The KT/V formula was used to assess the adequacy of hemodialysis. The URR common characteristic was also measured. Data were analyzed using statistical tests.

Results: The mean age of patients was 54.76±12.55 years. The mean of KT/V and URR were 0.26±0.92 and 0.47±0.09, respectively. The kt/v ratio was lower than 1.2 in 85.2% of the patients and the URR was lower than 65% in 97.8% of the patients.

Conclusion: The hemodialysis adequacy was low in 85.2% of the patients in the hospital and the hemodialysis efficacy indicators were lower than the standard measures. Assessment to find the reasons of low efficacy of hemodialysis is recommended.

---

Background & Aim: Promoting hope in hemodialysis patients is very important. Various methods have been suggested in order to raise hope in patients with chronic diseases. The aim of this study was to investigate the effect of an illness perception-based intervention on hope in patients with hemodialysis.
Methods & Materials: This is a randomized clinical trial (IRCT2016103130609N1) on 120 hemodialysis patients admitted in the dialysis department of Bou Ali Sina hospital in Qazvin from December to February 2016. The samples were randomly assigned into control and intervention groups. Before the intervention, questionnaires including demographic information, the Herth hope scale and a summarized form of illness perception were completed. The intervention group received the illness perception-based intervention in three sessions of 30 minutes each, prior to hemodialysis. Four weeks later, the Herth hope scale and illness perception questionnaire were re-completed by the both groups. Data were analyzed by descriptive statistics, t-test and ANCOVA using the SPSS software version 23.
Results: Results showed no statistically significant differences in hope scores between the two groups (P=0.5589) but after the intervention, hope scores significantly increased in the experimental group (36.54±2.98) compared to the control group (33.88±3.76) (P<0.001).
Conclusion: The result of the present study indicated the illness perception-based intervention was effective in enhancing hope in the patients underwent hemodialysis. Therefore, this intervention is recommended for hemodialysis patients.
 

---

Background & Aim: One of the important issues that affects the quality of hemodialysis is recirculation. Some researchers have suggested that the direction and distance of needle cannulation can affect the amount of recirculation. Therefore, this study aimed to investigate the effect of direction and distance of needle cannulation on recirculating of arteriovenous fistula in hemodialysis patients.
Methods & Materials: This clinical trial was performed on patients referred to the dialysis ward of Kamkar-Arabnia hospital affiliated to Qom University of Medical Sciences in 2016. The amount of recirculation was measured in 22 patients by urea based method, in four consecutive sessions. In each session, the distance and direction of the needles were three centimeters in opposite direction, three centimeters in same direction, six centimeters in opposite direction, and six centimeters in same direction. Data were analyzed using Stata and GEE test.
Results: The average age of participants was 53(16±0.75) years. In 41 dialysis cases (out of 88), the amount of recirculation was higher than 10%. The odds ratio for more than 10% recirculation for a distance of three centimeters compared to six centimeters was 2.05 (1.07-3.93) and for same direction compared to opposite direction was 1.98 (1.03-3.78).
Conclusion: The results of this study showed that the insertion of needles at a distance of six centimeters in opposite position had the lowest chance of recirculation. Therefore, the attention to proper insertion of needles can be effective in reducing recirculation and increasing the quality of dialysis.
Clinical trial registry: IRCT2016082929581N1
 

---

Background & Aim: End-stage renal failure requires careful and effective planning in the hemodialysis process to improve patients' quality of life and reduce complications. Therefore, this study aimed to investigate the impact of using cold dialysis solution on sleep quality and blood pressure changes during hemodialysis in patients with end-stage renal failure.
Methods & Materials: This blinded randomized clinical trial included 82 patients undergoing hemodialysis in Baqiyatallah and Milad hospitals in Tehran in 2023. Patients were randomly assigned to either the intervention group (41 individuals) or the control group (41 individuals). The intervention group received hemodialysis with cold dialysis solution (35°C), while the control group received standard dialysis solution (37°C) for 4 weeks. Data was collected using a demographic and disease characteristics form, Richard Campbell Sleep Quality Questionnaire (RCSQ), and a mercury sphygmomanometer. Data analysis was conducted using SPSS version 26 software, utilizing Mann-Whitney, independent t-test, chi-square, and paired t-test.
Results: The mean sleep quality score in the cold hemodialysis group (35°) after dialysis was significantly higher than the standard group (37°) (P=0.004). No significant difference was observed between the two groups before dialysis (P=0.759). There was no significant difference between the mean systolic and diastolic blood pressure scores before dialysis in the two groups. However, after dialysis, the reduction in blood pressure (systolic and diastolic) in the cold hemodialysis group was significantly less than in the standard group (P<0.001).
Conclusion: The results of this clinical trial showed that the use of cold dialysis solution during hemodialysis significantly improved the sleep quality of patients with end-stage renal failure and reduced blood pressure changes during treatment. These findings can be used to improve the treatment process and enhance the quality of life of these patients.
Clinical trial registry: IRCT20230521058244N1