Why does the choice of dialysate sodium concentration remain controversial?

Hemodialysis International
Kamonwan Tangvoraphonkchai, Andrew Davenport

Abstract

The choice of the ideal dialysate sodium concentration remains controversial. Most dialysis centers have a standard dialysate concentration. In theory, choosing a dialysate sodium concentration lower than serum sodium should result in an additional loss of sodium by diffusion with a reduction in the prevalence of hypertension and interdialytic weight gains (IDWGs) on one hand, but with potential increased risk of intradialytic hypotension and cramps on the other hand, and the opposite effects may accompany the choice of dialysate sodium concentrations greater than serum concentration. Although most studies have reported a reduction in IDWG with lower dialysate sodium concentrations, the effects on blood pressure control, and adverse intradialytic events have been variable. Different outcomes between studies may be partially explained by patient selection, with differences in dietary sodium intake, urinary sodium losses, and sodium stores in the body. In addition, multicenter trials potentially introduce additional confounders, including differences in local quality control of delivered dialysate sodium concentration and sodium measurements. Although there may be advantages for lower dialysate sodium concentration, observational...Continue Reading

References

Feb 1, 1996·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·W H van KuijkK M Leunissen
Mar 1, 1997·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M J FlaniganV S Lim
Apr 29, 1998·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·S KrautzigS Shaldon
Jul 31, 2002·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Karin MoretKarel M L Leunissen
Jul 31, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Joon Ho SongMoon-Jae Kim
Oct 26, 2002·American Journal of Physiology. Heart and Circulatory Physiology·Steven L Bealer
Dec 1, 2004·Kidney International·Hugh E de WardenerGraham A MacGregor
Apr 14, 2006·Kidney International·A Y-M Wang, K-N Lai
May 19, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Hla TheinMark R Marshall
Oct 4, 2007·Proceedings of the National Academy of Sciences of the United States of America·Hans OberleithnerMartin Hausberg
Jan 30, 2008·Journal of Occupational Medicine and Toxicology·Graham P Bates, Veronica S Miller
May 30, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Savas OzturkAlaattin Yildiz
Jul 9, 2008·The International Journal of Artificial Organs·A DavenportUNKNOWN PanThames Renal Audit Group
Nov 14, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Meral KayikciogluErcan Ok
Apr 9, 2009·International Journal of Epidemiology·Ian J BrownPaul Elliott
Jul 9, 2010·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Fernanda S MeiraDomingos O d'Avila
Dec 17, 2010·American Journal of Nephrology·Manfred HeckingGere Sunder-Plassmann
Dec 29, 2010·The American Journal of Medicine·Sushrut S WaikarSteven M Brunelli
Mar 23, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Aysun Aybal KutlugünMustafa Arici
Aug 31, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jair Munoz MendozaBrigitte Schiller
Sep 6, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Finnian R Mc CauslandSushrut S Waikar
Sep 29, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Manfred HeckingFriedrich K Port
Nov 5, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Manfred HeckingFriedrich K Port
Jan 17, 2012·International Urology and Nephrology·Hasan Ali GümrükçüoğluMustafa Tuncer
Nov 14, 2012·Journal of Nephrology·Carlo BasileCarlo Lomonte
Mar 16, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Jennifer E FlytheSteven M Brunelli
Jun 8, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rebecca J SucklingGraham A MacGregor
Nov 12, 2013·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Jahm PersaudAndrew Davenport
Feb 18, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Hugh C RaynerBruce M Robinson
Mar 22, 2014·American Journal of Hypertension·Manfred HeckingFriedrich K Port
May 14, 2014·American Journal of Nephrology·Mi Jung LeeShin-Wook Kang
Jul 1, 2014·Seminars in Dialysis·Cecile Courivaud, Andrew Davenport
Aug 8, 2014·Kidney International·Anke DahlmannJens M Titze
Nov 8, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Bergur V StefánssonNils-Olov Stålhammar
Nov 22, 2014·Current Opinion in Nephrology and Hypertension·David G Edwards, William B Farquhar
Dec 23, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jula K InrigRobert Toto
Apr 7, 2015·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Carlo BasileDavide Bolignano
Oct 27, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·UNKNOWN National Kidney Foundation
Jan 19, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ambreen GulPhilip G Zager
May 21, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Karl Skorecki, Walter G Wasser

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Citations

Feb 9, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Rupesh RainaBradley A Warady
Feb 18, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Kornchanok Vareesangthip, Andrew Davenport
May 10, 2020·Hemodialysis International·Kornchanok Vareesangthip, Andrew Davenport
Mar 30, 2021·Clinical Kidney Journal·Ali M Shendi, Andrew Davenport

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