Beyza Macunluoglu1, Hasan Ali Gumrukcuoglu2, Aydin Atakan3, Halit Demir4, Hamit Hakan Alp4, Aytac Akyol2, Serkan Akdag2, Ahmet Yavuz5, Zehra Eren6, Sıddık Keskin7, Elif Ari8. 1. Department of Nephrology, Uskudar State Hospital, 34000, Istanbul, Turkey. 2. Department of Cardiology, Yuzuncu Yil University, 65200, Van, Turkey. 3. Department of Nephrology, Fatih Sultan Mehmet Training Hospital, 34000, Istanbul, Turkey. 4. Department of Biochemistry, Yuzuncu Yil University, 65200, Van, Turkey. 5. Department of Nephrology, Kartal Training Hospital, 34890, Istanbul, Turkey. 6. Department of Nephrology, Yeditepe University, 34890, Istanbul, Turkey. 7. Department of Biostatistics, Yuzuncu Yil University, 65000, Van, Turkey. 8. Department of Nephrology, Kartal Training Hospital, 34890, Istanbul, Turkey. elifaribakir@gmail.com.
Abstract
PURPOSE: The purpose of the current prospective study was to evaluate the effects of low sodium dialysate on oxidative stress parameters, blood pressure (BP) and endothelial dysfunction in maintenance hemodialysis (HD) patients. METHODS: After baseline measurements were taken, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Oxidative stress parameters and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low sodium dialysate. Interdialytic weight gain (IDWG) and pre- and post-dialysis BP were monitored during the study. RESULTS: A total of 52 patients were enrolled and 41 patients completed the study. There was a significant reduction in systolic blood pressure at the end of the study [130.00 (90.00-190.00) vs. 120.00 (90.00-150.00), p < 0.001]. Similarly, there were significant improvements in IDWG [2670.00 (1670.00-4300.00) vs. 1986.00 (1099.00-3998.00), p < 0.001] and FMD % [7.26 (4.55-8.56) vs. 9.56 (6.55-12.05), p < 0.001]. Serum MDA levels (p < 0.001) were significantly decreased; serum SOD (p < 0.001) and GPx (p < 0.001) activities were significantly increased after low sodium HD compared to standard sodium HD. CONCLUSION: Our data seem to suggest a potential role of 137 mEq/L sodium dialysate for improving hemodynamic status, endothelial function and reducing oxidative stress than 140 mEq/L sodium dialysate in maintenance HD patients.
PURPOSE: The purpose of the current prospective study was to evaluate the effects of low sodium dialysate on oxidative stress parameters, blood pressure (BP) and endothelial dysfunction in maintenance hemodialysis (HD) patients. METHODS: After baseline measurements were taken, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Oxidative stress parameters and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low sodium dialysate. Interdialytic weight gain (IDWG) and pre- and post-dialysis BP were monitored during the study. RESULTS: A total of 52 patients were enrolled and 41 patients completed the study. There was a significant reduction in systolic blood pressure at the end of the study [130.00 (90.00-190.00) vs. 120.00 (90.00-150.00), p < 0.001]. Similarly, there were significant improvements in IDWG [2670.00 (1670.00-4300.00) vs. 1986.00 (1099.00-3998.00), p < 0.001] and FMD % [7.26 (4.55-8.56) vs. 9.56 (6.55-12.05), p < 0.001]. Serum MDA levels (p < 0.001) were significantly decreased; serum SOD (p < 0.001) and GPx (p < 0.001) activities were significantly increased after low sodiumHD compared to standard sodiumHD. CONCLUSION: Our data seem to suggest a potential role of 137 mEq/L sodium dialysate for improving hemodynamic status, endothelial function and reducing oxidative stress than 140 mEq/L sodium dialysate in maintenance HDpatients.
Authors: D S Celermajer; K E Sorensen; V M Gooch; D J Spiegelhalter; O I Miller; I D Sullivan; J K Lloyd; J E Deanfield Journal: Lancet Date: 1992-11-07 Impact factor: 79.321
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