Sodium fluxes during hemodialysis

Area of Science:

• Nephrology
• Clinical Chemistry

Background:

• Sodium balance is crucial for patients undergoing maintenance hemodialysis.
• Dialysate sodium concentration is a key factor influencing sodium balance during dialysis.

Purpose of the Study:

• To investigate the effect of varying dialysate sodium concentrations on sodium balance in hemodialysis patients.
• To assess the relationship between dialysate sodium and pre-treatment plasma sodium levels.
• To evaluate net sodium fluxes under different dialysate sodium conditions.

Main Methods:

• Patients received hemodialysis with three distinct dialysate sodium concentrations (125-132 mEq/l, 135-140 mEq/l, 145-150 mEq/l).
• Plasma sodium concentration available for diffusion was calculated using plasma sodium and protein levels.
• Sodium fluxes were calculated using hypernatremic or hyponatremic dialysate for 100 ml of plasma.

Main Results:

• Pre-treatment plasma sodium concentration was independent of the dialysate sodium concentration used.
• Calculated plasma sodium concentration available for diffusion was validated against ultrafiltrate measurements.
• No significant differences in net sodium fluxes were observed between hypernatremic and hyponatremic dialysis at steady state.

Conclusions:

• Dialysate sodium concentration does not influence pre-dialysis plasma sodium levels in maintenance hemodialysis.
• Hemodialysis with varying dialysate sodium concentrations does not result in significant differences in net sodium balance at steady state.