An acute rise of plasma Na<sup>+</sup>concentration associates with syndecan-1 shedding during hemodialysis

Koch, Josephine; Idzerda, Nienke M. A.; Ettema, Esmée M.; Kuipers, Johanna; Dam, Wendy; Born, Jacob van den; Franssen, Casper F. M.

doi:10.1152/ajprenal.00005.2020

Cited by 7 publications

(5 citation statements)

References 56 publications

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“…23,24 Predialysis plasma sodium concentration increased with the change from 135 to 140 mEq/L in this study, which raises another possible mechanism—direct effects of plasma sodium in stiffening the vascular endothelium. 25,26…”

Section: Discussionmentioning

confidence: 99%

Dialysate Sodium Lowering in Maintenance Hemodialysis

Miskulin,

Tighiouart,

Hsu

et al. 2024

CJASN

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Introduction: Lowering dialysate sodium may improve volume and blood pressure control in maintenance hemodialysis patients. Methods: We randomized 42 participants 2:1 to dialysate sodium 135 vs. 138 mEq/L for 6 months. This was followed by a 12 week extension in which sodium was increased to 140 mEq/L in low arm participants. The primary outcome was intradialytic hypotension (IDH). Secondary outcomes included dialysis disequilibrium symptoms, ER visits/hospitalizations, interdialytic weight gain, blood pressure (BP). Longitudinal changes across arms were analyzed using linear mixed regression. Results: Treatment to dialysate sodium 135 vs. 138 mEq/L was not associated with a difference in a change in the rate of IDH (mean change (95%CI) 2.8 (0.8,9.5) vs. 2.7 (1.1, 6.2) events per 100 treatments per month; ratio of slopes 0.96(0.26,3.61) or ER visits/hospitalizations (7.3 (2.3, 12.4) vs. 6.7 (2.9, 10.6) events per 100 patient months; difference 0.6(-6.9,5.8). Symptom score was unchanged in the 135 mEq/L arm (0.7 (-1.4,2.7) and decreased in the 138 mEq/l arm (5.0,8.5,2.0); difference 6.0 (2.1,9.8)). Interdialytic weight gain declined in the 135 mEq/L arm and was unchanged in the 138 mEq/L arm,(-0.3(-0.5,0.0) vs. 0.3 (0.0, 0.6) kg over 6 months; difference (-0.6 (-0.1,-1.0) kg). In the extension phase, raising dialysate sodium from 135 to 140 mEq/L was associated with an increase in interdialytic weight gain (0.2 (0.1, 0.3) kg), predialysis BP (7.0 (4.8, 9.2)/ 3.9 (2.6, 5.1) mm Hg) and a reduction in IDH [OR 0.66 (0.45, 0.97)]. Conclusion: Use of a dialysate sodium of 135 as compared with 138 mEq/L was associated with a small reduction in interdialytic weight gain without impact on IDH or predialysis BP, but with an increase in symptoms. Raising dialysate sodium from 135 to 140mEq/L was associated with a reduction in IDH, a small increase in interdialytic weight gain and a marked increase in predialysis BP.

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Section: Discussionmentioning

confidence: 99%

Dialysate Sodium Lowering in Maintenance Hemodialysis

Miskulin,

Tighiouart,

Hsu

et al. 2024

CJASN

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“…A multivariable linear regression analysis was performed to compare the change in syndecan-1 levels before/after hemodialysis and treatment with anticoagulants. The covariates in the regression model were age, sex, dry weight, and dialysis period 42 . These variables were selected a priori on the basis of previous studies.…”

Section: Discussionmentioning

confidence: 99%

Measuring The Concentration of Serum Syndecan-1 To Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

Kusuzawa

Suzuki

Okada

et al. 2021

Preprint

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Glycocalyx is present on the surface of healthy endothelium, and the concentration of serum syndecan-1 can serve as an injury marker. This study aimed to evaluate the hemodialysis-associated changes in the serum syndecan-1 concentration. This was a single-center, retrospective, observational study. Between March 2017 and December 2019, 145 patients who underwent hemodialysis at the Gifu University Hospital were enrolled. The median dialysis period and dialysis time were 63 months and 3.7 hours, respectively. The serum syndecan-1 concentration increased from 124.6 ± 107.8 ng/mL before hemodialysis to 229.0 ± 138.1 ng/mL after hemolysis (P < 0.001). Treatment with anticoagulant nafamostat mesylate inhibited hemodialysis-induced increase in the levels of serum syndecan-1 in comparison to unfractionated heparin. Dialysis time and the change in concentration of syndecan-1 were positively correlated, whereas the amount of body fluid removed and changes in the concentration of syndecan-1 were not correlated. The reduction in amount of body fluid removed and dialysis time inhibited the change in of syndecan-1 levels before and after hemodialysis. In conclusion, quantitative assessment of the endothelial glycocalyx injury during hemodialysis can be done by measuring the concentration of serum syndecan-1 which may aid in the selection of appropriate anticoagulants, hemodialysis time, and the amount of body fluid removed.

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“…A multivariable linear regression analysis was performed to compare the change in the syndecan-1 levels before/after hemodialysis and treatment with anticoagulants. The covariates in the regression model were age, sex, dry weight, and dialysis period ( 46 ). These variables were selected a priori based on previous studies.…”

Section: Methodsmentioning

confidence: 99%

Measuring the Concentration of Serum Syndecan-1 to Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

et al. 2021

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Glycocalyx is present on the surface of healthy endothelium, and the concentration of serum syndecan-1 can serve as an injury marker. This study aimed to assess endothelial injury using serum syndecan-1 as a marker of endothelial glycocalyx injury in patients who underwent hemodialysis. In this single-center, retrospective, observational study, 145 patients who underwent hemodialysis at the Gifu University Hospital between March 2017 and December 2019 were enrolled. The median dialysis period and time were 63 months and 3.7 h, respectively. The serum syndecan-1 concentration significantly increased from 124.6 ± 107.8 ng/ml before hemodialysis to 229.0 ± 138.1 ng/ml after hemodialysis (P < 0.001). Treatment with anticoagulant nafamostat mesylate inhibited hemodialysis-induced increase in the levels of serum syndecan-1 in comparison to unfractionated heparin. Dialysis time and the change in the syndecan-1 concentration were positively correlated. Conversely, the amount of body fluid removed and the changes in the syndecan-1 concentration were not significantly correlated. The reduction in the amount of body fluid removed and dialysis time inhibited the change in the syndecan-1 levels before and after hemodialysis. In conclusion, quantitative assessment of the endothelial glycocalyx injury during hemodialysis can be performed by measuring the serum syndecan-1 concentration, which may aid in the selection of appropriate anticoagulants, reduction of hemodialysis time, and the amount of body fluid removed.

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An acute rise of plasma Na⁺concentration associates with syndecan-1 shedding during hemodialysis

Cited by 7 publications

References 56 publications

Dialysate Sodium Lowering in Maintenance Hemodialysis

Dialysate Sodium Lowering in Maintenance Hemodialysis

Measuring The Concentration of Serum Syndecan-1 To Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

Measuring the Concentration of Serum Syndecan-1 to Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

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An acute rise of plasma Na+concentration associates with syndecan-1 shedding during hemodialysis

Cited by 7 publications

References 56 publications

Dialysate Sodium Lowering in Maintenance Hemodialysis

Dialysate Sodium Lowering in Maintenance Hemodialysis

Measuring The Concentration of Serum Syndecan-1 To Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

Measuring the Concentration of Serum Syndecan-1 to Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

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An acute rise of plasma Na⁺concentration associates with syndecan-1 shedding during hemodialysis