Efficacy of low dialysate sodium concentration on blood pressure and interdialytic weight gain among maintenance hemodialysis patients.

Hypertension is very common in end stage renal disease patients on hemodialysis and accelerates cardiovascular morbidity and mortality. The most important factor in achieving normal blood pressure in these patients is reaching dry weight. Sodium and extracellular fluid balance play a vital role in this regard. One hundred patients on regular hemodialysis three times weekly for more than 3 months duration were recruited in this randomized clinical study. The study was conducted for 12 hemodialysis sessions over 4 weeks duration at Helwan university hospitals. Patients were divided randomly into two groups, group 1 includes 50 patients received hemodialysis sessions with dialysate sodium 135 mmol/L, where group ll include 50 patients received hemodialysis sessions with dialysate sodium 140 mmol/L. Interdialytic weight gain, systolic, diastolic and mean arterial blood pressure were compared between the two groups to assess the effect of low dialysate sodium concentration on these parameters. One hundred maintenance hemodialysis patients were included in the analysis. Interdialytic weight gain was significantly lower in group I than group II (p= 0.007). Systolic, diastolic and mean arterial blood pressure were insignificantly different between both groups either pre, during or post-dialysis sessions (p= 0.215, 0.333, 0.179) respectively. Plasma sodium was significantly lower after one month in group I than group II (p= 0.032). Low dialysate sodium could decrease interdialytic weight gain and plasma sodium among maintenance hemodialysis patients, but it has no effect on blood pressure.