개별적 저나트륨 투석액 적용이 혈액투석 환자의 체중증가, 혈압 및 투석 중 부작용에 미치는 효과

The Effects of the Individual Application of Low Sodium Dialysate on Weight Gain, Blood Pressure, and Intradialytic Side Effects in Patients on Maintenance Hemodialysis

Purpose: The purpose of this study is to identify the effect of low sodium dialysate (LSD) rather than conventional dialysate on interdialytic weight gain (IWG), blood pressure (BP), and intradialytic side-effects (ISEs) in patients on maintenance hemodialysis (HD). Methods: The study was performed in 43 patients, who were treated in the university hospital over 8 weeks. Each participant's serum sodium set point was measured using dialysate sodium 140 mEq/L during the first 4 weeks. For the next 4 weeks dialysate sodium concentrate (134,136,and138 mEq/L) was provided to each participant but only to an experimental group (EG) (n=22) based on the individual set point, although 140 mEq/L dialysate was given to all of the control group (CG) (n=21). Consequently, outcomes including IWG, BP, and ISE were evaluated. Results: In EG, difference of pre-HD SBP (p=.047) and post-HD serum sodium (p=.006) were significantly decreased compared to CG. Also, ISEs was not more frequent in EG. However, the differences were not statistically significant, IWG (kg & %), pre-HD DBP, post-HD SBP & DBP, and serum osmolality in EG. Conclusion: Individual application of LSD in patients on maintenance hemodialysis is beneficial to decrease pre-HD SBP and post-HD serum sodium without increasing ISE. Therefore, LSD can be better treatment than conventional dialysate.