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Related Experiment Videos

Effect of dialysate composition on intercompartmental fluid shift.

S J Fleming1, J S Wilkinson, R N Greenwood

  • 1Department of Nephrology, St Bartholomew's Hospital, West Smithfield, London, United Kingdom.

Kidney International
|August 1, 1987
PubMed
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Dialysate sodium concentration significantly impacts fluid shifts during hemodialysis. Adjusting dialysate composition influences intercompartmental fluid movement and erythrocyte volume, crucial for patient fluid management.

Area of Science:

  • Nephrology
  • Fluid and Electrolyte Balance
  • Hemodialysis

Background:

  • Hemodialysis necessitates careful management of fluid balance.
  • Dialysate composition is a key factor influencing fluid shifts during hemodialysis.

Purpose of the Study:

  • To investigate the effect of varying dialysate sodium concentrations on intercompartmental fluid shifts and hemodynamics.
  • To determine how different dialysate sodium levels influence blood volume, plasma volume, and erythrocyte volume during hemodialysis without net ultrafiltration.

Main Methods:

  • 12 patients undergoing hemodialysis without net ultrafiltration.
  • Comparison of high (154 mmol/L), normal (140 mmol/L), and low (126 mmol/L) sodium concentration dialysates.
  • Monitoring of blood volume, plasma volume, erythrocyte volume, and hemodynamic parameters.

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Main Results:

  • High sodium dialysate increased blood and plasma volume while decreasing erythrocyte volume.
  • Low sodium dialysate decreased blood and plasma volume while increasing erythrocyte volume.
  • Changes in volume correlated with plasma sodium concentration and osmolality, not urea concentration.

Conclusions:

  • Dialysate composition significantly affects intercompartmental fluid movement.
  • Altered plasma concentrations of osmotically active substances explain the observed fluid shifts.
  • Dialysate sodium concentration is a critical factor in managing fluid balance during hemodialysis.