[Hemodialysis with increased sodium]

Area of Science:

• Nephrology
• Clinical Medicine
• Renal Replacement Therapy

Context:

• Hemodialysis procedures can be complicated by hemodynamic and osmolarity fluctuations.
• Technical adjustments, such as bicarbonate use and altered sodium concentrations, aim to mitigate these complications.
• Increased sodium concentration in dialysate is one such strategy explored to improve patient tolerance.

Purpose:

• To investigate the efficacy of increased sodium concentration during hemodialysis in reducing intradialytic complications.
• To compare the incidence of hypotension and interdialytic weight gain between standard and increased sodium hemodialysis protocols.

Summary:

• A study involving 30 hemodialysis patients compared standard sodium (135 mmol/L) with increased sodium (150 mmol/L) dialysate during the first half of treatment.
• Hypotension occurred in 20% of patients on standard sodium but in none with increased sodium.
• Average interdialytic weight gain was higher with increased sodium (2.526 kg) compared to standard sodium (1.486 kg).

Impact:

• Increased sodium concentration in dialysate is a useful intervention for hemodynamically unstable patients undergoing hemodialysis.
• This approach can reduce intradialytic hypotensive episodes.
• Careful monitoring of interdialytic weight gain is essential when implementing this strategy.