Andrew Davenport1. 1. Consultant Renal Physician/Honorary Senior Lecturer, Royal Free and University College Hospital Medical School, Centre for Nephrology, Royal Free Hospital, London, UK. Andrew.Davenport@royalfree.nhs.uk
Abstract
BACKGROUND/AIMS: Over the last three decades the standard dialysate sodium concentration has increased from 136 to 140 mmol/l (mEq/l) today. There has been great debate as to whether a reduction in dialysate sodium alone can lead to improved blood pressure control, and reduced inter-dialytic weight gain. METHODS: An audit was performed in 469 maintenance regular haemodialysis patients who dialysed in seven different centres under the care of one university medical school. RESULTS: Those centres which predominantly used a dialysate sodium of 140 mmol/l (mEq/l) had increased inter-dialytic weight gains, with more difficult blood pressure control, as not only did a greater percentage of patients require anti-hypertensive medication, but also more were prescribed multiple classes of anti-hypertensive agents. There was no difference in the frequency of symptomatic intra-dialytic hypotension. CONCLUSIONS: A reduction in dialysate sodium was associated with lower inter-dialytic weight gains, without any additional intra-dialytic hypotensive episodes. Those patients in whom the difference between the time-averaged dialysate sodium concentration and the midweek pre-dialysis serum sodium was positive result had increased inter-dialytic weight gains, compared to those with a negative value. Reduced dialysate sodium alone was not effective in controlling blood pressure without additional proper dietary sodium restriction. Copyright 2006 S. Karger AG, Basel.
BACKGROUND/AIMS: Over the last three decades the standard dialysate sodium concentration has increased from 136 to 140 mmol/l (mEq/l) today. There has been great debate as to whether a reduction in dialysate sodium alone can lead to improved blood pressure control, and reduced inter-dialytic weight gain. METHODS: An audit was performed in 469 maintenance regular haemodialysis patients who dialysed in seven different centres under the care of one university medical school. RESULTS: Those centres which predominantly used a dialysate sodium of 140 mmol/l (mEq/l) had increased inter-dialytic weight gains, with more difficult blood pressure control, as not only did a greater percentage of patients require anti-hypertensive medication, but also more were prescribed multiple classes of anti-hypertensive agents. There was no difference in the frequency of symptomatic intra-dialytic hypotension. CONCLUSIONS: A reduction in dialysate sodium was associated with lower inter-dialytic weight gains, without any additional intra-dialytic hypotensive episodes. Those patients in whom the difference between the time-averaged dialysate sodium concentration and the midweek pre-dialysis serum sodium was positive result had increased inter-dialytic weight gains, compared to those with a negative value. Reduced dialysate sodium alone was not effective in controlling blood pressure without additional proper dietary sodium restriction. Copyright 2006 S. Karger AG, Basel.
Authors: Hasan Ali Gümrükçüoğlu; Elif Arı; Aytaç Akyol; Serkan Akdağ; Hakkı Simşek; Musa Sahin; Yılmaz Güneş; Mustafa Tuncer Journal: Int Urol Nephrol Date: 2012-01-14 Impact factor: 2.370
Authors: Joanna Leigh Dunlop; Alain Charles Vandal; Janak Rashme de Zoysa; Ruvin Sampath Gabriel; Imad Adbi Haloob; Christopher John Hood; Philip James Matheson; David Owen Ross McGregor; Kannaiyan Samuel Rabindranath; David John Semple; Mark Roger Marshall Journal: BMC Nephrol Date: 2013-07-15 Impact factor: 2.388
Authors: Joanna Leigh Dunlop; Alain Charles Vandal; Janak Rashme de Zoysa; Ruvin Sampath Gabriel; Lukas Mathias Gerber; Imad Adbi Haloob; Christopher John Hood; John Hamilton Irvine; Philip James Matheson; David Owen Ross McGregor; Kannaiyan Samuel Rabindranath; John Benedict William Schollum; David John Semple; Mark Roger Marshall Journal: BMC Nephrol Date: 2014-07-21 Impact factor: 2.388
Authors: Francesco Locatelli; Sergio Stefoni; Thierry Petitclerc; Luigi Colì; Salvatore Di Filippo; Simeone Andrulli; Christine Fumeron; Giovanni Maria Frascà; Sibilla Sagripanti; Silvana Savoldi; Andrea Serra; Carmine Stallone; Filippo Aucella; Antonio Gesuete; Antonio Scarlatella; Francesco Quarello; Paola Mesiano; Peter Ahrenholz; Roland Winkler; Lise Mandart; Joan Fort; Christian Tielemans; Carlo Navino Journal: Nephrol Dial Transplant Date: 2012-05-04 Impact factor: 5.992
Authors: Anke Dahlmann; Kathrin Dörfelt; Florian Eicher; Peter Linz; Christoph Kopp; Irina Mössinger; Stephan Horn; Beatrix Büschges-Seraphin; Peter Wabel; Matthias Hammon; Alexander Cavallaro; Kai-Uwe Eckardt; Peter Kotanko; Nathan W Levin; Bernd Johannes; Michael Uder; Friedrich C Luft; Dominik N Müller; Jens M Titze Journal: Kidney Int Date: 2014-08-06 Impact factor: 10.612