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Normalization of increased sodium sensitivity by maintenance hemodialysis
H Matsuoka1, G Kimura, T Sanai
1Department of Medicine, National Cardiovascular Center, Osaka, Japan.
American Journal of Hypertension
|August 1, 1990
Summary
Blood pressure in chronic kidney disease patients becomes more sensitive to sodium and fluid. Hemodialysis therapy normalizes this sodium sensitivity, particularly in patients whose blood pressure is controlled.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Internal Medicine
Background:
- Hypertension in chronic renal failure is often sodium-sensitive.
- Renal function decline increases sensitivity to sodium and body fluid.
- Understanding sodium sensitivity in hemodialysis patients is crucial.
Purpose of the Study:
- To investigate if increased sodium sensitivity (SS) in hemodialysis (HD) patients normalizes during maintenance HD therapy.
- To assess the relationship between body fluid sensitivity (BFS) and sodium sensitivity (SS).
Main Methods:
- Measured body weight (BW) and mean arterial pressure (MAP) in HD patients (n=56) pre- and post-dialysis.
- Calculated BFS (delta MAP/delta BW) as an index for SS.
- Correlated interdialytic weight gain with sodium intake to validate BFS as an SS index.
Main Results:
- A strong positive correlation (r=0.79, P<.0001) was found between BFS and SS.
- Overall BFS decreased significantly from the introduction to the maintenance phase of HD (6.5 to 3.5 mm Hg/L, P<.01).
- This decrease was significant in patients with normalized blood pressure (6.2 to 2.9 mm Hg/L, P<.01) but not in those with persistent hypertension.
Conclusions:
- Body fluid sensitivity, as an index of sodium sensitivity, decreases during maintenance hemodialysis.
- Hemodialysis therapy can restore normal sodium sensitivity in patients with controlled blood pressure.
- Persistent hypertension in HD patients may be linked to a failure to normalize sodium sensitivity.