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Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis.

Olivera Marsenic1, Michael Anderson2, Kevin G Couloures3

  • 1Department of Pediatrics, Yale University, Pediatric Nephrology, New Haven, Connecticut, USA.

Hemodialysis International. International Symposium on Home Hemodialysis
|December 15, 2015
PubMed
Summary
This summary is machine-generated.

Lowering dialysate sodium (dNa) in pediatric hemodialysis patients improved blood pressure and fluid management. This study suggests a potential benefit of reduced dNa for children undergoing chronic hemodialysis.

Keywords:
Dialysate sodiumhypertensioninterdialytic weight gainpediatric hemodialysisultrafiltration

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Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Dialysis

Background:

  • Optimal dialysate sodium (dNa) concentrations for pediatric hemodialysis (HD) patients remain undetermined.
  • Adult studies suggest varying dNa levels impact outcomes, but pediatric data is lacking.

Purpose of the Study:

  • To investigate the effects of two constant dNa concentrations on pediatric chronic HD patients.
  • To assess the impact of lower dNa on clinical parameters and patient tolerance.

Main Methods:

  • A study involving 5 pediatric patients (age 4-17) on chronic HD.
  • 480 HD sessions were analyzed with dNa set at 140 mEq/L then 138 mEq/L for each patient.

Main Results:

  • Lowering dNa was linked to improved pre-HD hypertension.
  • Reduced interdialytic weight gain and decreased ultrafiltration needs were observed.
  • Lower sodium gradient was noted, with good tolerance despite variable predialysis serum sodium (sNa).

Conclusions:

  • Lowering dialysate sodium in pediatric HD patients demonstrated positive effects on blood pressure and fluid balance.
  • Further research is warranted to confirm these findings and explore even lower dNa levels for potential enhanced benefits in pediatric populations.