Effects Of Individualized Sodium Dialysate Prescription On Blood Pressure And Volume In Hemodialysis Patients

Background and purposeHypertension,volume and sodium overload are risk factors associated with the prognosis of patients with hemodialysis,reasonable control of sodium load is beneficial to optimize the management of blood pressure and volume,on this basis,changing the sodium concentration of dialysate may be one of the effective measures.The advantages and disadvantages,and security of the method are in exploring,but so far there is no unified conclusion,still need to further verify the effectiveness and safety.MethodsPatients were given routine hemodialysis for 4 weeks at baseline,with sodium concentration of dialysate 138mmol/L.Then,in the intervention period,the dialysate sodium concentration was adjusted to an individualized level for 4 weeks.After the end of the intervention period,the dialysate sodium concentration of all patients was restored to 138mmol/L,and followed up for 4 weeks.The differences of 44 h systolic blood pressure,44 h diastolic blood pressure in interdialysis,systolic blood pressure,diastolic blood pressure and number of antihypertensive drugs in all enrolled patients before and after intervention were compared.The clinical volume related indicators,overhydration,extracellular water,overhydration/extracellular water,the number of B-line,the degree of dryness and thirst in the mouth and the incidence of safety events before and after intervention were compared.Some of the above indicators were measured and compared in the 4-week follow-up after the end of intervention.ResultsAfter intervention,44 h systolic blood pressure,44 h diastolic blood pressure,diastolic blood pressure during dialysis,number of antihypertensive drugs were lower than those before intervention(P<0.05).The overhydration,overhydration/extracellular water,B-line score and the degree of dryness and thirst in the mouth were lower than those before intervention(P<0.05).There were no statistically significant differences in systolic blood pressure during dialysis,extracellular water and the clinical volume related indicators before and after intervention(P>0.05).There was no significant difference in the incidence of safety events after intervention(P>0.05).Conclusions1.The effects of individualized sodium prescription on blood pressure were observed in this study,including reducing 44 h systolic blood pressure,44 h diastolic blood pressure and diastolic blood pressure during dialysis,and reducing the number of antihypertensive drugs.2.The effect on volume included the improvement of some evaluation indexes related to volume,including the reduction of the overhydration,overhydration/extracellular water,B-line score,dry mouth and thirst degree.3.The safety evaluation results show that the method does not increase the incidence of security incidents.