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Dialysate sodium

Narges Sadat Zahed, Omid Gharooi, Latif Gachkar, Hajar Nikbakht
INTRODUCTION: Hypertension is one of the traditional risk factors of cardiovascular disease (CVD). Extra cellular volume expansion and Na retention remain the main cause of hypertension. OBJECTIVES: The aim of this study was to investigate the relation between concentration of Na dialysate and blood pressure (BP) in chronic hemodialysis (HD) patient. PATIENTS AND METHODS: This cross-sectional study was performed on 266 adult patients undergoing HD for at least three months...
2016: Journal of Renal Injury Prevention
Nasirul J Ekbal, Anne Consalus, Jahm Persaud, Andrew Davenport
Background The results of studies investigating the effects of hyponatraemic dialysates have been mixed, with some reporting positive effects including reduction in blood pressure and inter-dialytic weight gains, whereas others have not been able to demonstrate any effect. These studies assume that setting a lower dialysate sodium results in the delivery of a hyponatraemic dialysate. We therefore measured delivered sodium to determine reliability. Methods We measured dialysate sodium in 10 BBraun Dialog+(®) and 6 Fresenius 4008H dialysis machines, which had been set up to deliver a sodium of 136 mmol/L, using flame photometry and indirect ion selective electrode (ISE) methods...
October 2016: Hemodialysis International
Shuji Shimizu, Tsuyoshi Akiyama, Toru Kawada, Yusuke Sata, Michael James Turner, Masafumi Fukumitsu, Hiromi Yamamoto, Atsunori Kamiya, Toshiaki Shishido, Masaru Sugimachi
This study examined the mechanism of release of endogenous acetylcholine (ACh) in rabbit renal cortex by applying a microdialysis technique. In anesthetized rabbits, a microdialysis probe was implanted into the renal cortex and perfused with Ringer's solution containing high potassium concentration, high sodium concentration, a Na(+)/K(+)-ATPase inhibitor (ouabain), or an epithelial Na(+) channel blocker (benzamil). Dialysate samples were collected at baseline and during exposure to each agent, and ACh concentrations in the samples were measured by high-performance liquid chromatography...
September 22, 2016: Journal of Physiological Sciences: JPS
Ambreen Gul, Dana Miskulin, Antonia Harford, Philip Zager
PURPOSE OF REVIEW: This review focuses on recent advances in our understanding of intradialytic hypotension (IDH) and measures that may reduce its frequency. RECENT FINDINGS: The frequency and severity of IDH predict the risk for adverse clinical outcomes. The highest mortality risks associated with IDH were observed when the intradialytic systolic blood pressure (SBP) nadirs were <90 and <100 mmHg and the predialysis SBP were ≤159 mmHg or ≥160 mmHg, respectively...
November 2016: Current Opinion in Nephrology and Hypertension
Panagiotis I Georgianos, Rajiv Agarwal
The diagnosis and management of hypertension among patients on chronic dialysis is challenging. Routine peridialytic blood pressure recordings are unable to accurately diagnose hypertension and stratify cardiovascular risk. By contrast, blood pressure recordings taken outside the dialysis setting exhibit clear prognostic associations with survival and might facilitate the diagnosis and long-term management of hypertension. Once accurately diagnosed, management of hypertension in individuals on chronic dialysis should initially involve non-pharmacological strategies to control volume overload...
October 2016: Nature Reviews. Nephrology
François Paquette, Rémi Goupil, François Madore, Stéphan Troyanov, Josée Bouchard
The initiation of continuous renal replacement therapy (CRRT) in acute kidney injury (AKI) with severe hypernatremia is challenging since sodium concentrations in commercial replacement fluid (RF) and dialysate solutions are usually fixed at 140 mEq/L. We present a case of AKI with severe hypernatremia successfully treated with CRRT using commercial RF solutions customized to prevent rapid correction of hypernatremia. None of the few case reports published on hypernatremia and AKI requiring CRRT have included formulas to help modulate the sodium content in the solutions...
August 2016: Clinical Kidney Journal
Beyza Macunluoglu, Hasan Ali Gumrukcuoglu, Aydin Atakan, Halit Demir, Hamit Hakan Alp, Aytac Akyol, Serkan Akdag, Ahmet Yavuz, Zehra Eren, Sıddık Keskin, Elif Ari
PURPOSE: The purpose of the current prospective study was to evaluate the effects of low sodium dialysate on oxidative stress parameters, blood pressure (BP) and endothelial dysfunction in maintenance hemodialysis (HD) patients. METHODS: After baseline measurements were taken, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Oxidative stress parameters and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low sodium dialysate...
October 2016: International Urology and Nephrology
Natasa Eftimovska-Otovic, Risto Grozdanovski, Borjanka Taneva, Olivera Stojceva-Taneva
INTRODUCTION: Intradialytic hypertension with a prevalence of 15% among hemodialysis patients is with unknown pathophysiology, demographic, laboratoiy and clinical characteristic of patients, and it's influence on longtenn clinical effects (cardiovascular morbidity and mortality, rate of hospitalization). The aim of the study is to present the clinical, laboratoiy and demographic characteristics of patients with intradialytic hypertension in our dialysis center. MATERIALS AND METHODS: Out of 110 hemodialysis patients, 17 patients (15,45%) had intradialytic hypertension - started at a systolic pressure greater than 140 nun Hg or had an increase in systolic pressure more than 10 mm Hg during the session, and 17 patients were nonnotensive or had a drop in blood pressure dining the dialysis...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Nadine Döge, Stefan Hönzke, Fabian Schumacher, Benjamin Balzus, Miriam Colombo, Sabrina Hadam, Fiorenza Rancan, Ulrike Blume-Peytavi, Monika Schäfer-Korting, Anke Schindler, Eckart Rühl, Per Stahl Skov, Martin Church, Sarah Hedtrich, Burkhard Kleuser, Roland Bodmeier, Annika Vogt
Understanding penetration not only in intact, but also in lesional skin with impaired skin barrier function is important, in order to explore the surplus value of nanoparticle-based drug delivery for anti-inflammatory dermatotherapy. Herein, short-term ex vivo cultures of (i) intact human skin, (ii) skin pretreated with tape-strippings and (iii) skin pre-exposed to sodium lauryl sulfate (SLS) were used to assess the penetration of dexamethasone (Dex). Intradermal microdialysis was utilized for up to 24h after drug application as commercial cream, nanocrystals or ethyl cellulose nanocarriers applied at the therapeutic concentration of 0...
July 6, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Natasa Eftimovska-Otovic, Olivera Stojceva-Taneva, Risto Grozdanovski, Saso Stojcev
BACKGROUND: The degree to which the dialysate prescription and, in particular, the dialysate sodium concentration influences blood pressure and interdialytic weight gain (IDWG) via changes in sodium flux, plasma volume or the other parameters is not well understood. The aim of the study was to investigate whether dialysis patients will have some beneficial effects of dialysate sodium set up according to serum sodium or sodium modeling. MATERIAL AND METHODS: Ninety-two nondiabetic subjects (52 men and 40 women) performed 12 consecutive hemodialysis (HD) sessions (4 weeks) with dialysate sodium concentration set up on 138 mmol/L (standard sodium - first phase), followed by 24 sessions (second phase) wherein dialysate sodium was set up according to individualized sodium...
June 15, 2016: Open Access Maced J Med Sci
Colin I Cercamondi, Guus S M J E Duchateau, Rajwinder K Harika, Robin van den Berg, Peter Murray, Wieneke P Koppenol, Christophe Zeder, Michael B Zimmermann, Diego Moretti
Fe fortification of centrally manufactured and frequently consumed condiments such as bouillon cubes could help prevent Fe deficiency in developing countries. However, Fe compounds that do not cause sensory changes in the fortified product, such as ferric pyrophosphate (FePP), exhibit low absorption in humans. Tetra sodium pyrophosphate (NaPP) can form soluble complexes with Fe, which could increase Fe bioavailability. Therefore, the aim of this study was to investigate Fe bioavailability from bouillon cubes fortified with either FePP only, FePP+NaPP, ferrous sulphate (FeSO4) only, or FeSO4+NaPP...
August 2016: British Journal of Nutrition
Detlef H Krieter, Eric Devine, Thomas Körner, Marieke Rüth, Christoph Wanner, Manuelle Raine, Joachim Jankowski, Horst-Dieter Lemke
AIM: Protein-bound uraemic toxin accumulation causes uraemia associated cardiovascular morbidity. Enhancing the plasma ionic strength releases toxins from protein binding and makes them available for removal during dialysis. This concept was implemented through high sodium concentrations ([Na(+) ]) in the substituate of predilution haemodiafiltration at increased plasma ionic strength (HDF-IPIS). METHODS: Ex vivo HDF-IPIS with blood tested increasing [Na(+) ] to demonstrate efficacy and haemocompatibility...
June 4, 2016: Acta Physiologica
Mark Lambie, James Chess, Jun-Young Do, Hyunjin Noh, Hi-Bahl Lee, Yong-Lim Kim, Angela Summers, Paul Ford Williams, Sara Davison, Marc Dorval, Nick Topley, Simon John Davies
BACKGROUND AND OBJECTIVES: Glucose control is a significant predictor of mortality in diabetic peritoneal dialysis (PD) patients. During PD, the local toxic effects of intra-peritoneal glucose are well recognized, but despite large amounts of glucose being absorbed, the systemic effects of this in non-diabetic patients are not clear. We sought to clarify whether dialysate glucose has an effect upon systemic glucose metabolism. METHODS AND MATERIALS: We analysed the Global Fluid Study cohort, a prospective, observational cohort study initiated in 2002...
2016: PloS One
Maarten Wester, Karin G Gerritsen, Frank Simonis, Walther H Boer, Diënty H Hazenbrink, Koen R Vaessen, Marianne C Verhaar, Jaap A Joles
BACKGROUND: Patients on standard intermittent haemodialysis suffer from strong fluctuations in plasma potassium and phosphate. Prolonged dialysis with a wearable device, based on continuous regeneration of a small volume of dialysate using ion exchangers, could moderate these fluctuations and offer increased clearance of these electrolytes. We report in vivo results on the efficacy of potassium and phosphate adsorption from a wearable dialysis device. We explore whether equilibration of ion exchangers at physiological Ca(2+), Mg(2+) and hypotonic NaCl can prevent calcium/magnesium adsorption and net sodium release, respectively...
May 24, 2016: Nephrology, Dialysis, Transplantation
A Akyol, S Akdag, M Asker, H A Gumrukcuoglu, R Duz, K C Demirel, F Ozturk, M Yaman, M Sahin, H Simsek, M Tuncer, H Begenik
INTRODUCTION: Impaired diastolic flow is characterized by decreased left ventricular (LV) filling diastole, abnormal LV distensibility, or delayed relaxation. B-Type natriuretic peptide (BNP) is an indicator of various cardiovascular diseases and body volume status. The aim of this study was to determine whether the lowering of dialysate sodium (Na) levels is effective on LV systolic and diastolic parameters and BNP in the maintenance of hemodialysis patients. MATERIALS AND METHODS: The study included 49 chronic hemodialysis patients...
March 22, 2016: Human & Experimental Toxicology
Laurent Bitker, Frédérique Bayle, Hodane Yonis, Florent Gobert, Véronique Leray, Romain Taponnier, Sophie Debord, Alina Stoian-Cividjian, Claude Guérin, Jean-Christophe Richard
BACKGROUND: Hypotension is a frequent complication of intermittent hemodialysis (IHD) performed in intensive care units (ICUs). Passive leg raising (PLR) combined with continuous measurement of cardiac output is highly reliable to identify preload dependence, and may provide new insights into the mechanisms involved in IHD-related hypotension. The aim of this study was to assess prevalence and risk factors of preload dependence-related hypotension during IHD in the ICU. METHODS: A single-center prospective observational study performed on ICU patients undergoing IHD for acute kidney injury and monitored with a PiCCO® device...
2016: Critical Care: the Official Journal of the Critical Care Forum
D Batouche, K Elhalimi, N Benatta, K Litim, F Benhamed, S Zohret, N Boucherit, M Berexi-Reguig, Z Mentouri
OBJECTIFS: L'atteinte cardiaque représente la première cause de mortalité chez les patients hémodialysés. Le but de ce travail est d'évaluer l'impact de l'hémodialyse (HD) sur l'électrocardiogramme (ECG). MéTHODES: Nous avons réalisé une étude prospective sur 07 jours du mois d'avril 2015 incluant 06 patients en insuffisance rénale chronique terminale hémodialysés. Ont été exclus tous les patients ayant une cardiopathie dilatée, valvulaire. Un bilan biologique incluant les taux d'urée, de créatinine plasmatique, la natrémie et la kaliémie sont prélevés en pré et en post dialyse 3 fois par semaine pour chaque patient, ainsi qu'un enregistrement ECG...
December 2015: Annales de Cardiologie et D'angéiologie
Y Ben Ariba, Z Elloumi, Y Selmi, N Ben Abdelhafidh, B Louzir, J Labidi, S Othmani
BACKGROUND: The prevalence of hypertension (HT) remains high in hemodialysis patients ranging from 55% to 85%. Its origins are in the extracellular volume overload associated to the increased arterial resistance. The aim of our study was to describe the epidemiological, clinical and therapeutic characteristics in our hypertensive hemodialysis population. METHODS: This was a cross-sectional descriptive study about 61 hemodialysis patients between May and August 2014...
December 2015: Annales de Cardiologie et D'angéiologie
Bengt Rippe, Carl M Öberg
♦ Background: A modified version of automated peritoneal dialysis (APD) using not only variable dwell times but also variable fill volumes has been tested against conventional APD (cAPD) with fixed dwell volumes in a randomized controlled clinical study. The results have indicated that the modified schedule for APD, denoted adapted APD (aAPD), can lead to improved small solute clearances, and, above all, a markedly increased sodium removal (NaR). To theoretically test these results, we have modeled aAPD vs cAPD in computer simulations using the 3-pore model (TPM)...
February 4, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Jochen G Raimann, Christopher T Chan, John T Daugirdas, Tom Depner, Frank A Gotch, Tom Greene, George A Kaysen, Alan S Kliger, Peter Kotanko, Brett Larive, Robert Lindsay, Michael V Rocco, Glenn M Chertow, Nathan W Levin
In previous reports of the Frequent Hemodialysis Network trials, frequent hemodialysis (HD) reduced extracellular fluid (ECF) and left ventricular mass (LVM), with more pronounced effects observed among patients with low urine volume (UVol). We analyzed the effect of frequent HD on interdialytic weight gain (IDWG) and a time-integrated estimate of ECF load (TIFL). We also explored whether volume and sodium loading contributed to the change in LVM over the study period. Treatment effects on volume parameters were analyzed for modification by UVol and the dialysate-to-serum sodium gradient...
2016: Blood Purification
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