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Increasing the dialysate sodium concentration based on serum sodium concentrations exacerbates weight gain and thirst in hemodialysis patients.
Tohoku J Exp Med. 2013 06; 230(2):117-21.TJ

Abstract

Most dialysis centers adopt a standard dialysate sodium prescription. While pre-hemodialysis (HD) serum sodium levels remain relatively constant in each individual patient on chronic HD, these levels can vary between different patients. Therefore, a single dialysate sodium prescription may not be appropriate for all patients. Nineteen stable patients on maintenance HD were dialyzed for 9 HD sessions with their current dialysis solutions, followed by another 9 sessions using individualized prescriptions created by aligning dialysate sodium levels to each patient's serum sodium concentration. Patients were divided into 2 groups according to whether the average pre-HD serum sodium concentration was higher than (higher serum sodium group, n = 13) or equal to (equal sodium group, n = 5) the standard dialysate sodium concentration. Pre-HD serum sodium levels remained constant during entire study period in both groups. In higher serum sodium group, interdialytic weight gain increased after implementation of the sodium alignment (2.0 ± 0.3 kg vs. 2.3 ± 0.4 kg; P = 0.008). Thirst scores also increased in patients whose dialysate sodium was increased by 4 mmol/L (n = 7) (6.4 ± 1.5 vs. 7.6 ± 1.5, P = 0.015). There were no significant changes in blood pressure and intradialytic complications. In equal sodium group, significant differences were not observed in any parameters. Our results suggest that alignment of dialysate sodium levels to each patient's serum sodium concentration is of little benefit in hemodynamically stable patients who have pre-HD serum sodium concentrations higher than dialysate sodium concentration.

Authors+Show Affiliations

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23782720

Citation

Jung, Eun Sook, et al. "Increasing the Dialysate Sodium Concentration Based On Serum Sodium Concentrations Exacerbates Weight Gain and Thirst in Hemodialysis Patients." The Tohoku Journal of Experimental Medicine, vol. 230, no. 2, 2013, pp. 117-21.
Jung ES, Lee J, Lee JW, et al. Increasing the dialysate sodium concentration based on serum sodium concentrations exacerbates weight gain and thirst in hemodialysis patients. Tohoku J Exp Med. 2013;230(2):117-21.
Jung, E. S., Lee, J., Lee, J. W., Yoon, H. J., Kim, D. K., Oh, K. H., Kim, Y. S., Han, J. S., & Joo, K. W. (2013). Increasing the dialysate sodium concentration based on serum sodium concentrations exacerbates weight gain and thirst in hemodialysis patients. The Tohoku Journal of Experimental Medicine, 230(2), 117-21.
Jung ES, et al. Increasing the Dialysate Sodium Concentration Based On Serum Sodium Concentrations Exacerbates Weight Gain and Thirst in Hemodialysis Patients. Tohoku J Exp Med. 2013;230(2):117-21. PubMed PMID: 23782720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increasing the dialysate sodium concentration based on serum sodium concentrations exacerbates weight gain and thirst in hemodialysis patients. AU - Jung,Eun Sook, AU - Lee,Jeonghwan, AU - Lee,Jay Wook, AU - Yoon,Hyung-Jin, AU - Kim,Dong Ki, AU - Oh,Kook-Hwan, AU - Kim,Yon Su, AU - Han,Jin Suk, AU - Joo,Kwon Wook, PY - 2013/6/21/entrez PY - 2013/6/21/pubmed PY - 2014/1/18/medline SP - 117 EP - 21 JF - The Tohoku journal of experimental medicine JO - Tohoku J Exp Med VL - 230 IS - 2 N2 - Most dialysis centers adopt a standard dialysate sodium prescription. While pre-hemodialysis (HD) serum sodium levels remain relatively constant in each individual patient on chronic HD, these levels can vary between different patients. Therefore, a single dialysate sodium prescription may not be appropriate for all patients. Nineteen stable patients on maintenance HD were dialyzed for 9 HD sessions with their current dialysis solutions, followed by another 9 sessions using individualized prescriptions created by aligning dialysate sodium levels to each patient's serum sodium concentration. Patients were divided into 2 groups according to whether the average pre-HD serum sodium concentration was higher than (higher serum sodium group, n = 13) or equal to (equal sodium group, n = 5) the standard dialysate sodium concentration. Pre-HD serum sodium levels remained constant during entire study period in both groups. In higher serum sodium group, interdialytic weight gain increased after implementation of the sodium alignment (2.0 ± 0.3 kg vs. 2.3 ± 0.4 kg; P = 0.008). Thirst scores also increased in patients whose dialysate sodium was increased by 4 mmol/L (n = 7) (6.4 ± 1.5 vs. 7.6 ± 1.5, P = 0.015). There were no significant changes in blood pressure and intradialytic complications. In equal sodium group, significant differences were not observed in any parameters. Our results suggest that alignment of dialysate sodium levels to each patient's serum sodium concentration is of little benefit in hemodynamically stable patients who have pre-HD serum sodium concentrations higher than dialysate sodium concentration. SN - 1349-3329 UR - https://www.unboundmedicine.com/medline/citation/23782720/Increasing_the_dialysate_sodium_concentration_based_on_serum_sodium_concentrations_exacerbates_weight_gain_and_thirst_in_hemodialysis_patients_ L2 - https://japanlinkcenter.org/DN/JST.JSTAGE/tjem/230.117?lang=en&from=PubMed DB - PRIME DP - Unbound Medicine ER -