Time-averaged concentration of dialysate sodium relates with sodium load and interdialytic weight gain during sodium-profiling hemodialysis
Time-averaged concentration of dialysate sodium relates with sodium load and interdialytic weight gain during sodium-profiling hemodialysis
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DOI：
10.1053/ajkd.2002.34507
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发表时间：
2002-08-01
影响因子：
13.2
通讯作者：
Kim, MJ
中科院分区：
文献类型：
--
作者：
Song, JH;Lee, SW;Kim, MJ
背景：钠分析血液透析期间决定钠水平的因素很少被研究。我们假设透析液钠 (TAC(Na)) 的时间平均浓度与透析中钠负荷和透析间期并发症有关。方法：11 名患者接受了为期 6 周的周期：(1) 透析液钠浓度为 138 mmol/L (TAC(138)) 的常规血液透析和 (2) 透析液钠浓度为 150 至 138 mmol/L (TACNa，140 mmol/L [TAC(140)]) 的钠分析血液透析和 (3) 155 至 130 mmol/L（TACNa，147 mmol/L [TAC(147)]）。比较血清钠水平、体重增加、24小时血压以及透析中和透析间不适。结果：TAC（140）和TAC（147）期间血清钠水平升高（与透析前血清钠相比，P < 0.05）。透析中钠水平的变化与 TAC(Na) 呈正相关（r = 0.945；P < 0.001）。回归分析表明，TAC(Na)超过137.8 mmol/L时出现正钠负荷。透析间体重增加与 TAC(Na) 成比例增加（与其他时期相比，P < 0.05），呈正相关（r = 0.823；P < 0.001）。引起透析间体重增加小于 3 kg 的 TAC(Na) 估计小于 143.5 mmol/L。 TAC(147) 期间透析期间低血压减少，但透析间期不适增加（与 TAC(138) 和 TAC(140) 相比，P < 0.05）。 TAC147 期间平均 24 小时血压和压力负荷增加（与 TAC(138) 和 TAC(140) 相比，P < 0.05）。平均舒张压与 TAC(Na) 呈正相关 (r = 0.354；P < 0.05)。结论：TAC(Na)是钠分析血液透析期间钠负荷和透析间期并发症的决定因素。根据各个中心的方案确定最佳 TAC(Na) 将有助于避免钠负荷和体重过度增加。 (C) 2002 年，国家肾脏基金会 (National Kidney Foundation, Inc.)
Background: Factors determining sodium level during sodium-profiling hemodialysis rarely have been studied. We hypothesized that the time-averaged concentration of dialysate sodium (TAC(Na)) is related to intradialytic sodium load and interdialytic complications. Methods: Eleven patients underwent 6-week periods of (1) conventional hemodialysis with a dialysate sodium concentration of 138 mmol/L (TAC(138)) and (2) sodium-profiling hemodialysis with a dialysate sodium concentration of 150 to 138 mmol/L (TACNa, 140 mmol/L [TAC(140)]) and (3) 155 to 130 mmol/L (TACNa, 147 mmol/L [TAC(147)]). Serum sodium level, weight gain, 24-hour blood pressure, and intradialytic and interdialytic discomfort were compared. Results: Serum sodium levels increased during the TAC(140) and TAC(147) periods (P < 0.05 compared with predialysis serum sodium). Intradialytic change in sodium level correlated positively with TAC(Na) (r = 0.945; P < 0.001). Regression analysis indicates that positive sodium load occurred with TAC(Na) more than 137.8 mmol/L. Interdialytic weight gain increased in proportion to TAC(Na) (P < 0.05 compared with each other period), with a positive correlation (r = 0.823; P < 0.001). TAC(Na) causing interdialytic weight gain less than 3 kg was estimated to be less than 143.5 mmol/L. Intradialytic hypotension decreased, but interdialytic discomforts increased during the TAC(147) period (P < 0.05 compared with TAC(138) and TAC(140)). Mean 24-hour blood pressures and pressure loads increased during the TAC147 period (P < 0.05 compared with TAC(138) and TAC(140)). Mean diastolic blood pressure correlated positively with TAC(Na) (r = 0.354; P < 0.05). Conclusion: TAC(Na) is a factor determining sodium load and interdialytic complications during sodium-profiling hemodialysis. Defining the optimal TAC(Na) for individual centers based on their protocols will be helpful to avoid sodium load and excessive weight gain. (C) 2002 by the National Kidney Foundation, Inc.