Table 1.
Clinical consequences of dialysate sodium reduction in chronic hemodialysis patients
| Reference | N | Intervention time (wk) | Standard dialysate sodium (mEq/L) | Dialysate sodium reduction (mEq/L) | Reference for sodium reduction | BP | IDWG | HD-associated symptoms or nursing interventions | Comments | |
|---|---|---|---|---|---|---|---|---|---|---|
| Krautzig (39) | 8 | NR | 140 | 5 | Random | 2 | NR | NR | Dietary sodium restriction enforced; fixed decrease in dialysate Na | |
| Farmer (40) | 10 | 2 | 138–140 | 5 | Random | 2 | NS | NS | 24 h ABPM study; fixed decrease in dialysate Na | |
| Kooman (42) | 6 | 6 | 140 | 4 | Random | NS | NS | NR | Fixed decrease in dialysate Na | |
| Ferraboli (41) | 14 | 2 | 140 | 5 | Random | 2 | NR | NR | Fixed decrease in dialysate Na | |
| De Paula (5) | 27 | 3 | 138 | 3 (mean) | Pre-HD plasma sodium | 2 2 | Improvement | Individualized adjustment in dialysate Na | ||
| Lambie (30) | 16 | NR | 136a | Up to 6a | Random | 2 2 | Limit for dialysate conductivity reduction | Progressive titration on dialysate conductivity based on tolerability | ||
| Sayarlioglu (46) | 18 | 4 | NR | Varied according to Pre-HD Na | Pre-HD plasma sodium | 2 2 | NR | Decreased inferior vena cava diameter | ||
| Thein (43) | 52 | 16 | 141 | 3 | Random | 2 2 | NS | Database analysis, not a clinical trial; hypotensionprone patients included | ||
| Selby (55) | 10 | 6 | 136a | 2–4a | None | NS | NS | NS | Only 3 patients taking antihypertensive medications; Pre-HD extracellular water decreased; progressive titration on dialysate conductivity based on tolerability | |
BP, blood pressure; IDWG, interdialytic weight gain; HD, hemodialysis; NR, not reported; 2, significant decrease; ABPM, ambulatory blood pressure monitoring; NS, not significant; Pre-HD, pre-hemodialysis.
a
Measurement based on conductivity (dialysate conductivity × 10).