The Effects of the Individual Application of Low Sodium Dialysate on Weight Gain, Blood Pressure, and Intradialytic Side Effects in Patients on Maintenance Hemodialysis

개별적 저나트륨 투석액 적용이 혈액투석 환자의 체중증가, 혈압 및 투석 중 부작용에 미치는 효과

Purpose: The purpose of this study is to identify the effect of low sodium dialysate (LSD) rather than conventional dialysate on interdialytic weight gain (IWG), blood pressure (BP), and intradialytic side-effects (ISEs) in patients on maintenance hemodialysis (HD). Methods: The study was performed in 43 patients, who were treated in the university hospital over 8 weeks. Each participant's serum sodium set point was measured using dialysate sodium 140 mEq/L during the first 4 weeks. For the next 4 weeks dialysate sodium concentrate (134,136,and138 mEq/L) was provided to each participant but only to an experimental group (EG) (n=22) based on the individual set point, although 140 mEq/L dialysate was given to all of the control group (CG) (n=21). Consequently, outcomes including IWG, BP, and ISE were evaluated. Results: In EG, difference of pre-HD SBP (p=.047) and post-HD serum sodium (p=.006) were significantly decreased compared to CG. Also, ISEs was not more frequent in EG. However, the differences were not statistically significant, IWG (kg & %), pre-HD DBP, post-HD SBP & DBP, and serum osmolality in EG. Conclusion: Individual application of LSD in patients on maintenance hemodialysis is beneficial to decrease pre-HD SBP and post-HD serum sodium without increasing ISE. Therefore, LSD can be better treatment than conventional dialysate.