Sodium retention and hypertension with short dialysis

Exchangeable sodium was measured in 26 patients undergoing dialysis with a modestly shortened schedule of 14.8 hours weekly and related to blood-pressure control. The group was compared with 27 patients studied in 1969 during twice-weekly dialysis totalling 22 hours, and with 18 patients studied in 1973 during dialysis of 18--21 hours weekly in three sessions. Exchangeable sodium was significantly increased with short dialysis compared with the other schedules and, although mean blood pressure was not significantly increased, significantly more patients required antihypertensive treatment than in either 1969 or 1973. A trend towards more frequent resort to bilateral nephrectomy than in 1973 did not reach significance. Problems of hypertension and the side effects of its treatment, both medical and surgical, should be weighed against the social and economic advantages of short dialysis in deciding on the ideal schedule.