Two Variable Sodium Profiles and Adverse Effects During Hemodialysis: A Randomized Crossover Study

• Published in: Therapeutic apheresis and dialysis 2010-06, Vol.14 (3), p.328-333
• Main Authors: Meira, Fernanda S, Figueiredo, Ana E, Zemiarcki, Juscelino, Pacheco, Jaqueline, Poli-de-Figueiredo, Carlos E, D'Avila, Domingos O
• Format: Article
• Language: English
• Subjects: Adult; Adverse effect; Aged; Aged, 80 and over; Blood Pressure; Cross-Over Studies; Female; Humans; Hypotension; Hypotension - etiology; Kidney Failure, Chronic - therapy; Male; Middle Aged; Muscle cramp; Muscle Cramp - etiology; Prospective Studies; Renal dialysis; Renal Dialysis - adverse effects; Renal Dialysis - methods; Sodium - blood; Sodium profiling; Weight Gain; Young Adult
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/j.1744-9987.2009.00787.x

Intradialytic symptomatic hypotension and muscle cramps are frequent and disturbing adverse effects involving hemodialysis patients. The use of sodium profiling has been a proposed approach to preclude such events. The aim of the study was to compare the frequency of intradialytic adverse effects and changes in anthropometric and physiological variables without profiling and with two distinct sodium profiles. A prospective study randomized 22 stable hemodialysis patients to receive either a step (11 patients) or a linear (11 patients) dialysate sodium profile for 12 consecutive sessions, following a 12‐session steady sodium control period. After a wash‐out period of 12 sessions, the groups were crossed over for another 12‐session period. Frequency of adverse effects, interdialytic weight gain, pre‐ and post‐dialysis blood pressure were computed. The frequency of intradialytic adverse effects was significantly different between the control and either the step or linear periods (48.5%, 33.7%, and 36.0%, respectively; P