Dialysis symptoms and stabilization in long-term dialysis. Practical application of the CUSUM plot

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Abstract
Six symptoms that occur during hemodialysis were investigated to determine their frequency and to define when a patient''s condition becomes stable. Three symptoms, nausea, hypotension, and muscle cramps, stabilized after 13 dialysis treatments (approximately 1 mo.). Two symptoms, hypertension and vomiting, stabilized after 17 and 20 dialyses, respectively. Headache showed little variation per dialysis. The changes in the frequency of these symptoms were detected through the use of the cumulative sum technique (CUSUM). This technique was much more discriminating than the original data. Hemodialysis patients should not be considered stable for investigation of changes in techniques or therapy until after 1 1/2 mo. of dialysis. Even then, symptoms will be found during each dialysis.

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