Sodium removal and plasma tonicity balance are not different in hemodialysis and hemodiafiltration using high-flux membranes

Milia, Vincenzo La; Ravasi, Chiara; Carfagna, Fabio; Alberghini, Elena; Baragetti, Ivano; Buzzi, Laura; Ferrario, F; Furiani, Silvia; Barbone, Gaia Santagostino; Pontoriero, Giuseppe

doi:10.1007/s40620-018-00581-z

Cited by 10 publications

(12 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in agreement with recent studies addressing this concern. 16,17 As shown in our study, net sodium mass balance is virtually similar in both dialysis modalities (−222.6 vs. −235.3 mmol/session using the Flux model) on a dialysis session basis but also on a weekly cumulative basis. Interestingly, the Flux model clearly shows that sodium mass removal is mainly obtained by convection in hf-HD and ol-HDF.…”

Section: Discussionsupporting

confidence: 69%

Quantitative assessment of sodium mass removal using ionic dialysance and sodium gradient as a proxy tool: Comparison of high‐flux hemodialysis versus online hemodiafiltration

et al. 2021

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 69%

Quantitative assessment of sodium mass removal using ionic dialysance and sodium gradient as a proxy tool: Comparison of high‐flux hemodialysis versus online hemodiafiltration

et al. 2021

View full text Add to dashboard Cite

show abstract

“…We believe our findings are equally applicable to online HDF and HD, as the effect on plasma Na and Na balance was not different whether substitution fluid is applied or diffusive transfer across the membrane occurs. 7 A study in healthy subjects with well-functioning kidneys showed a nadir in plasma sodium approximately 1 h after oral water loading. 8 Reported time of last predialytic fluid ingestion was approximately 1.2 h before treatment start so this might also explain our observations in a population with end stage kidney disease.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of intradialytic sodium shifts during sodium controlled hemodialysis

Ponce¹,

Pinto²,

Wojke

et al. 2020

Int J Artif Organs

View full text Add to dashboard Cite

Plasma sodium shifts during hemodialysis treatments can be minimized by application of a sodium control algorithm. The present randomized cross-over trial was designed to apply this option on a large patient cohort and to observe the time course of plasma sodium over the treatment. In one study phase, patients received post-dilution online hemodiafiltration treatments with sodium control over the entire treatment. In the other study phase, patients received isolated ultrafiltration during the first 90 min followed by post-dilution online hemodiafiltration with sodium control for the remainder of the session, with the purpose to follow a possible initial equilibration process without the influence of a diffusive solute transfer. Each phase included six treatments and was delivered in randomized order. Eighty-one patients were enrolled, 77 patients could be analyzed as intention-to-treat population. The difference of the mean plasma sodium concentration between start and end of the treatment was −0.60 mmol/L (confidence interval −0.88 to −0.32) and −0.15 mmol/L (confidence interval −0.43 to 0.13), for sodium control and isolated ultrafiltration during the first 90 min followed by post-dilution online hemodiafiltration with sodium control, respectively. The functionality of the sodium control option could be confirmed and further reproduced in a bigger population of dialysis patients, providing the basis to investigate the clinical benefit of individually adjusting dialysate sodium in further clinical studies.

show abstract

“…Also in a recent cross-over study by La Milia et al . [18], in 47 HD patients, the sodium removal and the plasma tonicity during the dialysis session were equivalent between the two dialysis modalities. Also, we have been able to use the routine data of fluid assessment implemented in the NephroCare dialysis units.…”

Section: Discussionmentioning

confidence: 99%

Is high-volume post-dilution haemodiafiltration associated with risk of fluid volume imbalance? A national multicentre cross-sectional cohort study

Chazot

Deleuze²,

Fadel

et al. 2019

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

Background Fluid overload is frequent among hemodialysis (HD) patients. Dialysis therapy itself may favor sodium imbalance from sodium dialysate prescription. As on-line hemodiafiltration (OL-HDF) requires large amounts of dialysate infusion, this technique can expose to fluid accumulation in case of a positive sodium gradient between dialysate and plasma. To evaluate this risk, we have analyzed and compared the fluid status of patients treated with HD or OL-HDF in French NephroCare centers. Method This is a cross-sectional and retrospective analysis of prevalent dialysis patients. Data were extracted from the EUCLID5 data base. Patients were split in 2 groups (HD and OL-HDF) and compared as whole group or matched patients for fluid status criteria including predialysis relative fluid overload (RelFO%) status from the BCM®. Results 2242 patients (age 71 years; female: 39%; vintage: 38 months; Charlson index: 6) were studied. 58% of the cohort were prescribed post-dilution OL-HDF. Comparing the HD and OL-HDF groups, there was no difference between HD and OL-HDF patients regarding the predialysis systolic BP, the interdialytic weight gain, the dialysate-plasma sodium gradient, and the predialysis RelFO%. The stepwise logistic regression did not find dialysis modality (HD or OL-HDF) associated with fluid overload or high predialysis systolic blood pressure. In OL-HDF patients, monthly average convective or weekly infusion volumes per session were not related with the presence of fluid overload. Conclusions In this cross-sectional study we did not find association between the use of post-dilution OL-HDF and markers of fluid volume excess. Aligned dialysis fluid sodium concentrations to patient predialysis plasma sodium and regular monitoring of fluid volume status by bioimpedance spectroscopy may have been helpful to manage adequately the fluid status in both OL-HDF and HD patients.

show abstract

Sodium removal and plasma tonicity balance are not different in hemodialysis and hemodiafiltration using high-flux membranes

Cited by 10 publications

References 31 publications

Quantitative assessment of sodium mass removal using ionic dialysance and sodium gradient as a proxy tool: Comparison of high‐flux hemodialysis versus online hemodiafiltration

Quantitative assessment of sodium mass removal using ionic dialysance and sodium gradient as a proxy tool: Comparison of high‐flux hemodialysis versus online hemodiafiltration

Evaluation of intradialytic sodium shifts during sodium controlled hemodialysis

Is high-volume post-dilution haemodiafiltration associated with risk of fluid volume imbalance? A national multicentre cross-sectional cohort study

Contact Info

Product

Resources

About