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Improvement of visit-to-visit SBP variability with lowering dialysate sodium concentration in patients undergoing

Hoda Mahmoud Mohammad Abdulaziz1, Hadeer Gomaa2, Ghada El-Said1

  • 1Mansoura Nephrology and Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura.

Journal of Hypertension
|February 6, 2026
PubMed

Insights

Lowering dialysate sodium in hemodialysis reduces systolic blood pressure variability and interdialytic weight gain. This intervention shows promise for improving cardiovascular health in dialysis patients.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Hypertension and blood pressure variability (BPV) are critical risk factors for cardiovascular disease in hemodialysis (HD) patients.
  • Sodium load contributes to fluid retention, weight gain, and hypertension in HD patients.
  • Understanding modifiable factors like dialysate sodium is crucial for managing cardiovascular risk in HD.

Purpose of the Study:

  • To investigate the impact of reduced dialysate sodium concentration on visit-to-visit blood pressure variability (BPV) in hemodialysis patients.
  • To assess the effect of lower dialysate sodium on interdialytic weight gain (IDWG).

Main Methods:

  • Eighty-nine hemodialysis patients were randomized to receive standard (143 mmol/l) or reduced (140 mmol/l) dialysate sodium for 3 months.
  • Visit-to-visit BPV was measured using standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic blood pressure (SBP).
  • Interdialytic weight gain (IDWG) and intradialytic adverse events were also monitored.

Main Results:

  • Reduced dialysate sodium significantly decreased SD, CV, and ARV of SBP.
  • No significant differences were found in diastolic BPV between the groups.
  • The reduced sodium group showed a significant decrease in IDWG after 3 months, with comparable adverse events.

Conclusions:

  • Lowering dialysate sodium concentration effectively reduces systolic BPV and IDWG in hemodialysis patients.
  • These findings suggest a potential benefit for cardiovascular health, warranting further long-term investigation.
Abstract

Keywords:
blood pressure variabilitydialysate sodium loweringhemodialysis

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