scholarly journals MP704REGIONAL DIFFERENCES IN THE ASSOCIATIONS BETWEEN PRESCRIBED DIALYSATE SODIUM CONCENTRATION AND INTERDIALYTIC WEIGHT GAIN IN THE DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY: A CALL FOR QUALITY ASSURANCE?

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii689-iii690
Author(s):  
Manfred Hecking ◽  
Michelle Wong ◽  
Friedrich Port ◽  
Bruce Robinson ◽  
Keith McCullough
Keyword(s):  
Quality Assurance ◽  
Weight Gain ◽  
Practice Patterns ◽  
Sodium Concentration ◽  
Interdialytic Weight Gain ◽  
Dialysis Outcomes ◽  
Dialysate Sodium

scholarly journals Association Between Dialysate Sodium Concentration And Interdialytic Weight Gain In Patients Undergoing Twice Weekly Haemodialysis

2020 ◽  
Author(s):  
Soraiya Manji ◽  
Jasmit Shah ◽  
Ahmed Twahir ◽  
Ahmed Sokwala
Keyword(s):  
Weight Gain ◽  
Univariate Analysis ◽  
Sodium Concentration ◽  
University Hospital ◽  
Exact Test ◽  
Interdialytic Weight Gain ◽  
Significant Difference ◽  
Blood Pressures ◽  
The Mean ◽  
Dialysate Sodium

Abstract BackgroundChronic kidney disease is highly prevalent across the globe with more than two million people worldwide requiring renal replacement therapy. Interdialytic weight gain is the change in body weight between two sessions of haemodialysis. Higher interdialytic weight gain has been associated with an increase in mortality and adverse cardiovascular outcomes. It has long been questioned whether using a lower dialysate sodium concentration during dialysis would reduce the interdialytic weight gain and hence prevent these adverse outcomes.MethodsThis study was a single blinded cross-over study of patients undergoing twice weekly haemodialysis at the Aga Khan University Hospital, Nairobi and Parklands Kidney Centre. It was conducted over a twelve-week period and patients were divided into two groups: dialysate sodium concentration of 137meq/l and 140meq/l. These groups switched over after a six-week period without a washout period. Univariate analysis was conducted using Fisher’s exact test for categorical data and Mann Whitney test for continuous data. Results41 patients were included in the analysis. The mean age was 61.37 years, and 73% were males. The mean duration for dialysis was 2.53 years. The interdialytic weight gain was not significantly different between the two groups (2.14 for the 137meq/l group and 2.35 for the 140meq/l group, p = 0.970). Mean blood pressures were as follows: pre-dialysis: DNa 137meq/l: systolic 152.14 ± 19.99, diastolic 78.99 ± 12.20, DNa 140meq/l: systolic 156.95 ± 26.45, diastolic 79.75 ± 11.25 (p = 0.379, 0.629 respectively). Post-dialysis: DNa 137meq/l: systolic 147.29 ± 22.22, diastolic 77.85 ± 12.82 DNa 140meq/l: systolic 151.48 ± 25.65, diastolic 79.66 ± 15.78 (p = 0.569, 0.621 respectively). ConclusionThere was no significant difference in the interdialytic weight gain as well as pre dialysis and post dialysis systolic and diastolic blood pressures between the two groups. Therefore, using a lower dialysate sodium concentration does not appear useful in altering the interdialytic weight gain although further studies with a larger sample size are warranted.

scholarly journals Effect of dialysate sodium concentration on interdialytic weight gain in hemodialysis patients

2021 ◽  
Vol 3 (2) ◽  
pp. 107-111
Author(s):  
Dr. Spandana Vuyyuru ◽  
Dr. K Vara Prasada Rao ◽  
Dr. Moturu Venkata Viswanath ◽  
Dr. Praveen Kumar Kolla ◽  
Dr. Raghavendra Sadineni
Keyword(s):  
Weight Gain ◽  
Sodium Concentration ◽  
Hemodialysis Patients ◽  
Interdialytic Weight Gain ◽  
Dialysate Sodium

scholarly journals Opinion on the (Hemo)dialysate Sodium Prescription: Dialysate Sodium Prescription Should Not Be Considered in Isolation

2021 ◽  
Vol 1 (2) ◽  
pp. 154-156
Author(s):  
Khai Ping Ng ◽  
Indranil Dasgupta
Keyword(s):  
Weight Gain ◽  
Low Temperature ◽  
Sodium Concentration ◽  
Dialysis Patients ◽  
Short Term ◽  
Volume Management ◽  
Interdialytic Weight Gain ◽  
Dialysate Sodium ◽  
Cardiovascular Stability

With advances in hemodialysis technology and the desire to achieve cardiovascular stability during dialysis, prescribed dialysate sodium concentration has gradually increased over the years. Short-term trials suggest low dialysate sodium (<138 mEq/L) is beneficial in reducing interdialytic weight gain, pre- and post-dialysis BP, and predialysis serum sodium; but it increases intradialytic hypotensive episodes. We believe dialysate sodium prescription cannot be considered in isolation. Our approach is to use patient symptoms, meticulous fluid volume management and low temperature dialysate in conjunction with neutral dialysate sodium in managing our dialysis patients. Long-term trials are needed to inform optimum dialysate sodium prescription.

scholarly journals Evidence from Studies of Patient-Reported Outcomes Supports a Policy of Using a Dialysate Sodium Concentration of 140 mEq/L for the Majority of Patients

2021 ◽  
Vol 1 (2) ◽  
pp. 147-148
Author(s):  
Hugh C. Rayner
Keyword(s):  
Sodium Concentration ◽  
Surrogate Outcome ◽  
Interdialytic Weight Gain ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
Dialysis Outcomes ◽  
Mental And Physical Health ◽  
Dialysate Sodium

The best evidence available to guide a policy for prescribing the dialysate sodium concentration, [DNa], comes from large randomly selected observational studies, such as the Dialysis Outcomes and Practice Patterns Study (DOPPS). These show that, after adjustment for differences in demographics and comorbidity, using a [DNa] lower than 140 mEq/L is associated with patients taking longer to recover after a dialysis treatment, worse symptoms of kidney failure, a higher score for the burden of kidney disease and worse mental and physical health-related quality of life. It is also associated with greater risks of being admitted to hospital and dying. These outcomes are more important than any medically determined surrogate outcome, such as the control of blood pressure or interdialytic weight gain. The most appropriate policy for prescribing the dialysate sodium concentration is to use a [DNa] of 140 mEq/L for the majority of patients.

Sign in / Sign up

Export Citation Format

Share Document