Comparison of Prescribed and Measured Dialysate Sodium: A Quality Improvement Project

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Ambreen GulPhilip G Zager

Abstract

There is controversy regarding the optimal dialysate sodium concentration for hemodialysis patients. Dialysate sodium concentrations of 134 to 138 mEq/L may decrease interdialytic weight gain and improve hypertension control, whereas a higher dialysate sodium concentration may offer protection to patients with low serum sodium concentrations and hypotension. We conducted a quality improvement project to explore the hypothesis that prescribed and delivered dialysate sodium concentrations may differ significantly. Cross-sectional quality improvement project. 333 hemodialysis treatments in 4 facilities operated by Dialysis Clinic, Inc. Measure dialysate sodium to assess the relationships of prescribed and measured dialysate sodium concentrations. Magnitude of differences between prescribed and measured dialysate sodium concentrations. Dialysate sodium measured pre- and late dialysis. The least square mean of the difference between prescribed minus measured dialysate sodium concentration was -2.48 (95% CI, -2.87 to -2.10) mEq/L. Clinics with a greater number of different dialysate sodium prescriptions (clinic 1, n=8; clinic 2, n=7) and that mixed dialysate concentrates on site had greater differences between prescribed and measured...Continue Reading

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Citations

Jul 28, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Holly KramerMichael Rocco
Sep 27, 2016·Hemodialysis International·Nasirul J EkbalAndrew Davenport
Jan 31, 2018·Hemodialysis International·Catherine CourteauCatherine L Weber
Feb 27, 2018·Hemodialysis International·Kamonwan Tangvoraphonkchai, Andrew Davenport
Jan 16, 2019·The Cochrane Database of Systematic Reviews·Joanna L DunlopMark R Marshall
Apr 18, 2017·Nephron Extra·Emilie Trinh, Catherine Weber
Jan 10, 2017·Seminars in Dialysis·Jennifer E Flythe, Finnian R Mc Causland
Dec 29, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jack Kit-Chung NgUNKNOWN RESOLVE Steering Committee
Jan 18, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Daniele Marcelli, Carlo Basile
Oct 17, 2020·Seminars in Dialysis·Mohammad Tinawi, Bahar Bastani
Mar 30, 2021·Clinical Kidney Journal·Ali M Shendi, Andrew Davenport

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