[Studies on the sodium concentration of dialysate solution for continuous ambulatory peritoneal dialysis]

Overloaded sodium(Na) induces the expansion of extracellular volume in case with severe renal insufficiency. Accordingly, in patients undergoing CAPD, the Na balance via trans-peritoneum is the critical determinant of fluid state. This study was performed to clarify the trans-peritoneal Na kinetics in patients using standard dialysate (Na: 132mEq/1,2-1), and to explore the clinical effects of lower Na concentration solution. Peritoneal dialysis effluent obtained from 87 patients was analysed [1.5% dextrose dialysate (D): 33 bags, 2.5%D: 54 bags]. In terms of net-Na removal, no significant relation was found with serum Na level. Whereas, a significant positive relation was found with ultrafiltration (UF) volume (p < 0.01). Net-Na removal was 10.0 +/- 3.3mEq in 1.5%D and 30.2 +/- 1.8 mEq in 2.5%D (mean +/- SEM). On the other hand, ultra low sodium concentration dialysate (ULNaD, Na level: 98mEq/1, Osm:340mOsm/1, 2l) was effectively used for the purpose of increasing Na removal. Net-Na removal was 78.1 +/- 5. 6mEq after 4-hr dwelling (n = 18). ULNaD was applied to ten patients who showed signs of overhydration, using once a day consecutively instead of standard one. After 9 days (mean) in this regimen, signs of overhydration were disappeared. Significant reductions in their body weight and fall in blood pressure were found compared to the periods before commencement of ULNaD, showing remarkable increase in Na removal (p < 0.01, respectively). No significant changes were found in serum Na level or UF volume.(ABSTRACT TRUNCATED AT 250 WORDS)