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"Physiological" and "pharmacological" dialysate sodium concentrations

F Locatelli, L Pedrini, R Ponti

    The International Journal of Artificial Organs
    |January 1, 1982
    PubMed
    Summary

    Using physiological or pharmacologically high dialysate sodium concentrations improved cardiovascular stability in hemodialysis patients. Achieving dry body weight corrected cellular overhydration, preventing feared long-term cardiovascular side effects.

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    Area of Science:

    • Nephrology
    • Cardiovascular Medicine
    • Internal Medicine

    Background:

    • Uremic patients undergoing regular hemodialysis often experience cardiovascular instability.
    • Dialysate sodium concentration (NaD) is a critical factor influencing fluid and electrolyte balance during hemodialysis.

    Purpose of the Study:

    • To investigate the impact of different dialysate sodium concentrations on cardiovascular stability in hemodialysis patients.
    • To assess the long-term cardiovascular effects of "physiological" and "pharmacologically high" NaD.

    Main Methods:

    • Forty-three uremic patients on regular hemodialysis were studied.
    • Patients were dialyzed with a "physiological" NaD (142 mEq/l) followed by a "pharmacologically high" NaD (148 mEq/l).
    • Blood pressure, body weight, and cardiovascular stability were monitored throughout the study periods.

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    Main Results:

    • Initial use of "physiological" NaD led to significant drops in blood pressure and body weight.
    • Subsequent use of "pharmacologically high" NaD improved cardiovascular stability with no significant increase in blood pressure.
    • Convective removal of water and sodium improved patient well-being and cardiovascular stability.

    Conclusions:

    • Both "physiological" and "pharmacologically high" NaD, when used with appropriate dry body weight achievement, can improve cardiovascular stability in hemodialysis patients.
    • Effective correction of cellular overhydration is key to preventing long-term cardiovascular side effects.
    • Dialysate sodium management is crucial for optimizing hemodialysis outcomes.