Effects of Increasing Diffusive Sodium Removal on Blood Pressure Control in Hemodialysis Patients with Optimal Dry WeightZhou Y.-L. · Liu J. · Ma L.-J. · Sun F. · Shen Y. · Huang J. · Cui T.-G.
Department of Nephrology, Chao-Yang Hospital, Capital Medical University, Beijing, China
Background: Sodium, apart from volume, may have an independent effect on blood pressure (BP) regulation. Methods: Sixteen hypertensive hemodialysis patients were enrolled, who have achieved their dry weight assessed by bioimpedance methods, with pre-dialysis plasma sodium levels slightly higher than the facility dialysate sodium concentration 138 mmol/l. After a 1-month period of dialysis with standard dialysate sodium concentration of 138 mmol/l, the patients were followed up for a 4-month period with dialysate sodium set at 136 mmol/l. Results: Along with lowering dialysate sodium, there were significant decreases (-10 mm Hg and -6 mm Hg) in 44-hour ambulatory systolic and diastolic BP at 4 months. Interdialytic weight gain adjusted to the estimated dry weight mildly but significantly decreased (4.81 ± 1.51 vs. 4.36 ± 1.37%, p = 0.047). The post-dialysis volume parameters remained constant throughout the study period. Conclusion: In selected hypertensive hemodialysis patients with optimal dry weight, increasing diffusive sodium removal resulted in significant BP decrease. It was probably due to a volume-independent effect.
© 2013 S. Karger AG, Basel
Received: July 10, 2012
Accepted: December 11, 2012
Published online: March 19, 2013
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 2, Number of References : 31
Vol. 35, No. 1-3, Year 2013 (Cover Date: June 2013)
Journal Editor: Ronco C. (Vicenza)
ISSN: 0253-5068 (Print), eISSN: 1421-9735 (Online)
For additional information: http://www.karger.com/BPU