Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec;12(2):66-73.
doi: 10.5049/EBP.2014.12.2.66. Epub 2014 Dec 31.

Effect of dialysate sodium concentration on sodium gradient and hemodialysis parameters

Haifeng Jin  1 , Seung Yun Lee  2 , Si Nae Lee  2 , Joon Ho Song  2 , Moon-Jae Kim  2 , Seoung Woo Lee  2
Affiliations

Effect of dialysate sodium concentration on sodium gradient and hemodialysis parameters

Haifeng Jin et al. Electrolyte Blood Press. 2014 Dec.

Abstract

This retrospective study was performed to determine the ranges of the sodium gradient (SG) between the dialysate sodium concentration (DNa) and serum sodium concentration (SNa) in hemodialysis (HD) patients and to examine the relationships between HD parameters over a 1 year period. Fifty-five clinically stable HD patients, who had been on HD >2 years were enrolled. Monthly HD [ultrafiltration (UF) amount, systolic blood pressure (SBP), frequency of intradialytic hypotension (IDH)] and laboratory data were collected and 12-month means were subjected to analysis. The SG was calculated by subtracting SNa from prescribed DNa. Mean SG values were 1.5±3.3 (range -5.6~9.1). SG was positively related to DNa and the frequency of IDH. A higher SG was associated with larger UF amounts and SBP reduction during HD. The percentages of patients with a SG ≥3mEq/L increased as DNa increased. On the other hand, SG was not found to be associated with SNa or pre-HD SBP. DNa appears to cause a significant increase in SG, and this seems to be related to HD parameters, such as, UF amount and IDH.

Keywords: Dialysis solutions; Renal dialysis; Sodium.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interests to declare.

Figures

Fig. 1
Fig. 1
Distribution of the mean (A) SNa, (B) csNa, and (C) csNag values of the study subjects. SNa: serum sodium concentration, csNa: SNa corrected for void volume and the Gibbs-Donnan effect, csNag: csNa corrected for glucose concentration.
Fig. 2
Fig. 2
Bland-Altman plot between (A) SNa and csNa, and between (B) SNa and csNag. SNa: serum sodium concentration, csNa: SNa corrected for void volume and the Gibbs-Donnan effect, csNag: csNa corrected for glucose concentration.
Fig. 3
Fig. 3
Correlation between mean SGna and mean ultrafiltration (UF) amount (r=0.40, p=0.002).
Fig. 4
Fig. 4
Correlation between mean SGna and mean (pre - post) SBP (r=0.34, p=0.012). ΔSBP: (pre - post) SBP.
Fig. 5
Fig. 5
Number of patients (filled squares) of (A) SGna, (B) SGcna, and (C) SGcnag ≥3 mEq/L) among total patients (white squares) according to DNa concentration.
Fig. 6
Fig. 6
Correlation between the frequency of intradialytic hypotension (IDH) and mean SGna (r=0.358, p=0.007).
See this image and copyright information in PMC

References

    1. Santos SFF, Peixoto AJ. Sodium balance in maintenance hemodialysis. Semin Dial. 2010;23:549–555. - PubMed
    1. Flanigan MJ. Sodium Flux and Dialysate Sodium in Hemodialysis. Semin Dial. 2007;11:298–304.
    1. Munoz Mendoza J, Sun S, Chertow GM, Moran J, Doss S, Schiller B. Dialysate sodium and sodium gradient in maintenance hemodialysis: a neglected sodium restriction approach? Nephrol Dial Transplant. 2011;26:1281–1287. - PMC - PubMed
    1. Hecking M, Kainz A, Hörl WH, Herkner H, Sunder-Plassmann G. Sodium setpoint and sodium gradient: influence on plasma sodium change and weight gain. Am J Nephrol. 2011;33:39–48. - PubMed
    1. Petitclerc T, Jacobs C. Dialysis sodium concentration: what is optimal and can it be individualized? Nephrol Dial Transplant. 1995;10:596–599. - PubMed

LinkOut - more resources