Document Detail


Time-averaged concentration of dialysate sodium relates with sodium load and interdialytic weight gain during sodium-profiling hemodialysis.
MedLine Citation:
PMID:  12148101     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Factors determining sodium level during sodium-profiling hemodialysis rarely have been studied. We hypothesized that the time-averaged concentration of dialysate sodium (TAC(Na)) is related to intradialytic sodium load and interdialytic complications. METHODS: Eleven patients underwent 6-week periods of (1) conventional hemodialysis with a dialysate sodium concentration of 138 mmol/L (TAC(138)) and (2) sodium-profiling hemodialysis with a dialysate sodium concentration of 150 to 138 mmol/L (TAC(Na), 140 mmol/L [TAC(140)]) and (3) 155 to 130 mmol/L (TAC(Na), 147 mmol/L [TAC(147)]). Serum sodium level, weight gain, 24-hour blood pressure, and intradialytic and interdialytic discomfort were compared. RESULTS: Serum sodium levels increased during the TAC(140) and TAC(147) periods (P < 0.05 compared with predialysis serum sodium). Intradialytic change in sodium level correlated positively with TAC(Na) (r = 0.945; P < 0.001). Regression analysis indicates that positive sodium load occurred with TAC(Na) more than 137.8 mmol/L. Interdialytic weight gain increased in proportion to TAC(Na) (P < 0.05 compared with each other period), with a positive correlation (r = 0.823; P < 0.001). TAC(Na) causing interdialytic weight gain less than 3 kg was estimated to be less than 143.5 mmol/L. Intradialytic hypotension decreased, but interdialytic discomforts increased during the TAC(147) period (P < 0.05 compared with TAC(138) and TAC(140)). Mean 24-hour blood pressures and pressure loads increased during the TAC(147) period (P < 0.05 compared with TAC(138) and TAC(140)). Mean diastolic blood pressure correlated positively with TAC(Na) (r = 0.354; P < 0.05). CONCLUSION: TAC(Na) is a factor determining sodium load and interdialytic complications during sodium-profiling hemodialysis. Defining the optimal TAC(Na) for individual centers based on their protocols will be helpful to avoid sodium load and excessive weight gain.
Authors:
Joon Ho Song; Seoung Woo Lee; Chang-Kook Suh; Moon-Jae Kim
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:  40     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-30     Completed Date:  2002-08-12     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:  291-301     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by the National Kidney Foundation, Inc.
Affiliation:
Department of Internal Medicine, Inha University College of Medicine, Inchon City, Korea.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects,  physiology
Dialysis Solutions / administration & dosage,  metabolism*
Female
Humans
Hypertension / etiology
Male
Middle Aged
Renal Dialysis / adverse effects,  methods*
Sodium / administration & dosage*,  adverse effects,  blood,  metabolism*
Time Factors
Weight Gain / drug effects,  physiology*
Chemical
Reg. No./Substance:
0/Dialysis Solutions; 7440-23-5/Sodium
Comments/Corrections
Erratum In:
Am J Kidney Dis 2002 Dec;40(6):1357

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


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