Document Detail

Dialysate sodium delivery can alter chronic blood pressure management.
MedLine Citation:
PMID:  9041214     Owner:  NLM     Status:  MEDLINE    
Low dialysate sodium concentrations can reduce postdialysis thirst and serum sodium activity, but patients typically experience dialysis hypotension, fatigue, disequilibrium, and cramps. "High-sodium" hemodialysis minimizes dialysis disequilibrium but increases the serum sodium activity of most patients. Programmed "variable-sodium" dialysis can minimize dialysis discomfort but may also alter the sodium kinetics from those of "high-sodium" dialysis. We designed a cross-over study with random order assignment to determine whether a "variable-sodium" dialysis program could reduce the blood pressure of dialysis patients without increasing dialysis morbidity. Dialysis with a dialysate sodium of 140 mEq/L was compared with dialysis with a programmed exponential decrease of dialysate sodium from 155 mEq/L to 135 mEq/L. Dialysate sodium was then held constant at 135 mEq/L for the final half hour of dialysis. Eighteen patients completed the 7-month study, each receiving 3.5 months of experimental and 3.5 months of standard therapy. Programmed "variable-sodium" dialysis resulted in a reduction in antihypertensive drug use without alterations in predialysis blood pressure, interdialytic weight gain, ultrafiltration tolerance, or the frequency of symptomatic dialysis cramps or hypotension. Patients did, however, have lower postdialysis standing blood pressures and higher postdialysis target weights during programmed "variable-sodium" dialysis.
M J Flanigan; Q T Khairullah; V S Lim
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  29     ISSN:  0272-6386     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-03-26     Completed Date:  1997-03-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  383-91     Citation Subset:  IM    
University of Iowa Hospitals and Clinics, Iowa City 52240-6040, USA.
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MeSH Terms
Aged, 80 and over
Blood Pressure Determination / instrumentation,  methods
Chi-Square Distribution
Chronic Disease
Cross-Over Studies
Hemodialysis Solutions / administration & dosage*,  adverse effects
Hypertension / blood,  etiology,  therapy*
Middle Aged
Renal Dialysis / adverse effects,  instrumentation,  methods*,  statistics & numerical data
Sodium / administration & dosage*,  adverse effects,  blood
Time Factors
Reg. No./Substance:
0/Hemodialysis Solutions; 7440-23-5/Sodium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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