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Hyponatremia in peritoneal dialysis patients.

J Uribarri¹, S Prabhakar, T Kahn

¹Renal Division, Mount Sinai School of Medicine, New York, USA. jaime.uribarri@mssm.edu

Clinical Nephrology

|February 18, 2004

Summary

Low serum sodium is uncommon in peritoneal dialysis (PD). PD sodium loss is primarily determined by dialysate ultrafiltration volume, necessitating proportional salt intake to maintain normal serum sodium levels.

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Area of Science:

Nephrology
Dialysis
Electrolyte balance

Background:

Low serum sodium (hyponatremia) is infrequently observed in patients undergoing peritoneal dialysis (PD).
This is unexpected given the kidneys' crucial role in regulating water and sodium homeostasis.

Observation:

Two cases of persistent hyponatremia during PD were studied.
Balance studies and 24-hour measurements of dialysate sodium and volume output were conducted in chronic PD patients.

Findings:

In PD, net daily sodium removal is significantly correlated with net daily dialysate volume removed (r=0.65).
Serum sodium concentration is not directly related to daily PD sodium removal.
A direct linear correlation exists between serum and dialysate sodium concentrations (r=0.8).

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Implications:

Net dialysate ultrafiltration volume is the primary factor driving sodium loss during PD.
Water removal during PD inherently leads to sodium loss.
Maintaining normal serum sodium requires salt intake to match dialysis-induced water loss, though the regulatory mechanisms remain unclear.