Document Detail

Two variable sodium profiles and adverse effects during hemodialysis: a randomized crossover study.
MedLine Citation:
PMID:  20609187     Owner:  NLM     Status:  MEDLINE    
Intradialytic symptomatic hypotension and muscle cramps are frequent and disturbing adverse effects involving hemodialysis patients. The use of sodium profiling has been a proposed approach to preclude such events. The aim of the study was to compare the frequency of intradialytic adverse effects and changes in anthropometric and physiological variables without profiling and with two distinct sodium profiles. A prospective study randomized 22 stable hemodialysis patients to receive either a step (11 patients) or a linear (11 patients) dialysate sodium profile for 12 consecutive sessions, following a 12-session steady sodium control period. After a wash-out period of 12 sessions, the groups were crossed over for another 12-session period. Frequency of adverse effects, interdialytic weight gain, pre- and post-dialysis blood pressure were computed. The frequency of intradialytic adverse effects was significantly different between the control and either the step or linear periods (48.5%, 33.7%, and 36.0%, respectively; P < 0.001). No significant differences in interdialytic weight gain or pre-dialysis blood pressure were detected between treatment periods. The mean post-dialysis systolic blood pressure was lower in the linear period (128 +/- 21; 127 +/- 20; 123 +/- 22 mm Hg, for the control, step and linear periods, respectively; P = 0.014). Seven patients benefited from sodium profiling, yet two became more symptomatic. Overall, both sodium profiles were associated with fewer intradialytic adverse effects. Intradialytic symptomatic hypotension occurred less often with the step profile, while a tendency to fewer cramps was associated with the linear profile. However, sodium profiling may not benefit every dialysis patient and should be individually evaluated.
Fernanda S Meira; Ana E Figueiredo; Juscelino Zemiarcki; Jaqueline Pacheco; Carlos E Poli-de-Figueiredo; Domingos O d'Avila
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  14     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  328-33     Citation Subset:  IM    
Department of Internal Medicine, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
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MeSH Terms
Aged, 80 and over
Blood Pressure*
Cross-Over Studies
Hypotension / etiology
Kidney Failure, Chronic / therapy*
Middle Aged
Muscle Cramp / etiology
Prospective Studies
Renal Dialysis / adverse effects*,  methods
Sodium / blood*
Weight Gain
Young Adult
Reg. No./Substance:

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