Ionic mass balance and blood volume preservation during a high, standard, and individualized dialysate sodium concentration

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2002-08, Vol.17 (8), p.1463-1469
• Main Authors: Moret, Karin, Hassell, Daxenos, Kooman, Jeroen P., van der Sande, Frank, Gerlag, Paul G. G., van den Wall Bake, A. Warmold L., van de Bogaart, Jarno, Leunissen, Karel M. L.
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; blood volume; Blood Volume - physiology; dialysate sodium concentration; Emergency and intensive care: renal failure. Dialysis management; Female; haemodialysis; Humans; Intensive care medicine; ionic mass balance; Male; Medical sciences; Renal Dialysis - methods; Reproducibility of Results; Sodium - blood; Ultrafiltration; Water-Electrolyte Balance
• ISSN: 0931-0509; 1460-2385; 1460-2385
• DOI: 10.1093/ndt/17.8.1463

Background. Although a higher dialysate sodium concentration (DNa) is frequently used to improve haemodynamic stability during haemodialysis, few studies have compared ionic mass balance (IMB) during different DNa. Moreover, DNa is usually a standard prescription, whereas inter‐individual pre‐dialytic serum sodium levels may differ widely. The aims of the study were to assess IMB and the decline in blood volume (ΔBV) during isovolaemic HD as well as during HD combined with ultrafiltration (UF) during DNa [140], DNa [144], and an individualized DNa [ind], in which DNa is equal to pre‐HD plasma conductivity×10. Methods. IMB and plasma conductivity were assessed by on‐line conductivity measurements (Diascan®; Hospal®) in 13 HD patients. After 1 h of isovolaemic HD, measurements were continued during UF+HD until dry weight. ΔBV was assessed by an optical method (Hemoscan®). Results. During isovolaemic HD with DNa [140] and [144], Pre‐Na was significantly related to IMB (r=0.83 and r=0.61; P