Background and objective: Hypotension and Muscle cramp are the common complications of Hemodialysis. One approach that has recently been proposed to prevent this complication is the change in the concentration of sodium and ultrafiltration. The purpose of this study was to investigate the influence of sodium dialysate variation and ultrafiltration in preventing hypotension and muscle cramp during hemodialysis process.
Material and Methods: In this clinical trial study, 44 Hemodialysis patients were divided randomly into four groups. For each group, four treatment protocols (six-session Hemodialysis) were conducted. Protocol A: Sodium dialysate and ultrafiltration were constant. Protocol II: sodium was linear and ultrafiltration was constant. Protocol III: Sodium and ultrafiltration were linear. Protocol IV (routine): Sodium and ultrafiltration were constant. Using Chi-Square and relative risk, the data was analyzed (P<0.05).
Results: The incidence of hypotension, at the end of the fourth hour of dialysis in Protocol 3, was significantly decreased compared to that of routine method (P<0.05), while at the end of first, second and third hour, this difference was not significant. Muscle cramp in the routine method was more than other protocols (P=0.034). The relative risk of muscle cramp in the routine method was 2.08 times of protocol I, 1.09 of Protocol II, 2.08 of protocol III.
Conclusion: Sodium and ultrafiltration profile is simple and cost-free, and it reduces the incidence of hypotension and muscle cramp during dialysis. Thus, we recommend using sodium and UF profile instead of routine protocol to reduce these effects.

Material and Methods: This descriptive-analytic study was conducted on 58 eligible, randomly selected patients of 165 hemodialysis patients referred to Panje Azar Hospital in Gorgan. The instruments were a demographic checklist, Fatigue Severity Scale, Beck Anxiety Inventory, and the Beck Depression Inventory. The data was analyzed by SPSS 17 software using Mann-Whitney, Kruskal-Wallis, Spearman's correlation coefficient and linear regression. 

Results: The mean average of fatigue in all patients was 1.66±4.76. Twenty-six of the participants (44.8%) expressed that they suffer from moderate anxiety, 17 (29.3%) from severe depression and 43 (74.1%) from poor quality of sleep. The relationship between fatigue and anxiety (P = 0.006, r = 0.353) and depression (P≤.001, r=0.525) was directly significant whereas the relationship is not significant for sleep quality. 

Conclusion: Given the high prevalence of fatigue in hemodialysis patients and the impact of multiple factors, we strongly recommend that care providers should consider these factors to improve patients’ quality of life.

Results: Overall, the frequency of hypotension in routine method was 18% and in cool dialysis was 5%. It means that hypotention in cool dialysis is significantly less than that of routin method (P<0.004). Furthermore, the mean of hypotension related interventions in both groups was also significant (P<0.001). 

Conclusion: Owing to the effect of cool dialysate temperature on stabilizing hemodynamic parameters, we recommend using this method during hemodialysis in hypotensive patients.