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Audit of the Effect of Dialysate Sodium Concentration on Inter-Dialytic Weight Gains and Blood Pressure Control in Chronic Haemodialysis Patients

Audit of the Effect of Dialysate Sodium Concentration on Inter-Dialytic Weight Gains and Blood... 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Nephron Clinical Practice Karger

Audit of the Effect of Dialysate Sodium Concentration on Inter-Dialytic Weight Gains and Blood Pressure Control in Chronic Haemodialysis Patients

Davenport, Andrew
Nephron Clinical Practice , Volume 104 (3): 6 – Oct 1, 2006
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Publisher
Karger
Copyright
© 2006 S. Karger AG, Basel
eISSN
1660-2110
DOI
10.1159/000094544
Publisher site
See Article on Publisher Site

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.

Journal

Nephron Clinical Practice – Karger

Published: Oct 1, 2006

Keywords: Sodium; Dialysate; Blood pressure

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