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Original Paper

Long-Term Stability of Serum Sodium in Hemodialysis Patients

Peixoto A.J.a, b · Gowda N.c · Parikh C.R.a, b · Santos S.F.F.d

Author affiliations

aMedical Service, VA Connecticut Healthcare System, West Haven, Conn., bSection of Nephrology, Yale University School of Medicine, New Haven, Conn., and cDivision of Nephrology, Medical University of South Carolina, Charleston, S.C., USA; dDepartment of Internal Medicine (Nephrology), UERJ (State University of Rio de Janeiro), Rio de Janeiro, Brazil

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Blood Purif 2010;29:264–267

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 29, 2009
Accepted: August 21, 2009
Published online: January 12, 2010
Issue release date: March 2010

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Background: A direct relationship between dialysate-to-plasma sodium gradient, blood pressure and interdialytic weight gain exists in hemodialysis (HD) patients. The aim of this study was to delineate the long-term variability of serum sodium in HD patients. Methods: We performed a retrospective cohort analysis of serum sodium and other analytes routinely evaluated in 100 stable chronic HD patients observed for 12 months. Results: Individual levels across the cohort varied from 122 to 145 mM, but 12-month intraindividual coefficients of variation for sodium were low (pre-HD = 1.6%; post-HD = 1.8%) with overall variability similar to that related to laboratory assay variability especially when compared with other analytes (3.1–30.8%). Pre-HD serum sodium had a trend toward hyponatremia (mean 136 ± 0.8 mM). Conclusion: Serum sodium is stable over time in HD patients. Pre-HD serum sodium may be used as a parameter for individualizing dialysate sodium prescription.

© 2010 S. Karger AG, Basel


References

  1. de Paula FM, Peixoto AJ, Pinto LV, Dorigo D, Patricio PJ, Santos SF: Clinical consequences of an individualized dialysate sodium prescription in hemodialysis patients. Kidney Int 2004;66:1232–1238.
  2. Flanigan MJ: Role of sodium in hemodialysis. Kidney Int Suppl 2000;76:72–78.
    External Resources
  3. Hillier TA, Abbott RD, Barrett EJ: Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med 1999;106:399–403.
  4. Levin NW, Zhu F, Keen M: Interdialytic weight gain and dry weight. Blood Purif 2001;19:217–221.
  5. Keen ML, Gotch FA: The association of the sodium ‘setpoint’ to interdialytic weight gain and blood pressure in hemodialysis patients. Int J Artif Organs 2007;30:971–979.
  6. Li SY, Chen JY, Chuang CL, Chen TW: Seasonal variations in serum sodium levels and other biochemical parameters among peritoneal dialysis patients. Nephrol Dial Transplant 2008;23:687–692.
  7. Cheung AK, Yan G, Greene T, Daugirdas JT, Dwyer JT, Levin NW, Ornt DB, Schulman G, Eknoyan G: Seasonal variations in clinical and laboratory variables among chronic hemodialysis patients. J Am Soc Nephrol 2002;13:2345–2352.
  8. Bourque CW: Central mechanisms of osmosensation and systemic osmoregulation. Nat Rev Neurosci 2008;9:519–531.
  9. Santos SF, Peixoto AJ: Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients. Clin J Am Soc Nephrol 2008;3:522–530.
  10. Sergyeva O, Usvyat P, Kotanko N, Levin W: Positive intradialytic sodium gradients relate to reduced survival in chronic hemodialysis patients (abstract). J Am Soc Nephrol 2008;19:71–72.
  11. Thein H, Haloob I, Marshall MR: Associations of a facility level decrease in dialysate sodium concentration with blood pressure and interdialytic weight gain. Nephrol Dial Transplant 2007;22:2630–2639.
  12. Ritz E, Dikow R, Morath C, Schwenger V: Salt – a potential ‘uremic toxin’? Blood Purif 2006;24:63–66.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 29, 2009
Accepted: August 21, 2009
Published online: January 12, 2010
Issue release date: March 2010

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU


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