Long-Term Stability of Serum Sodium in Hemodialysis PatientsPeixoto A.J.a, b · Gowda N.c · Parikh C.R.a, b · Santos S.F.F.d
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
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
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
- 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.
Flanigan MJ: Role of sodium in hemodialysis. Kidney Int Suppl 2000;76:72–78.
- Hillier TA, Abbott RD, Barrett EJ: Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med 1999;106:399–403.
- Levin NW, Zhu F, Keen M: Interdialytic weight gain and dry weight. Blood Purif 2001;19:217–221.
- 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.
- 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.
- 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.
- Bourque CW: Central mechanisms of osmosensation and systemic osmoregulation. Nat Rev Neurosci 2008;9:519–531.
- 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.
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.
- 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.
- Ritz E, Dikow R, Morath C, Schwenger V: Salt – a potential ‘uremic toxin’? Blood Purif 2006;24:63–66.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.