The Chronic Efficacy and Safety of High Sodium Dialysate: Double-Blind, Crossover Study

Henrich, William L.; Woodard, Terry; McPhaul, John J.

doi:10.1016/s0272-6386(82)80093-0

Cited by 78 publications

(36 citation statements)

References 8 publications

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“…A direct relation between an increase in intracellular sodium concentration and an increase in arterial tone by an increase in free cytosolic calcium is suggested [34]. However, Henrich et al [35] increased exchangeable sodium in hemodialysis patients by elevating the dialysate sodium concentration over a 6-week period. Although interdialytic weight gain increased, there was no effect on blood pressure control.…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Control and Hemodynamic Changes in Patients on Long Time Dialysis Treatment

et al. 1998

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In dialysis patients blood pressure can be well controlled with long dialysis (3 times a week for 8 h) in contrast to a more common short dialysis regime (3 times a week for 4 h). We studied whether the good blood pressure control in patients on long dialysis as compared to patients on short dialysis was associated with a decrease in extracellular fluid volume. Two-day interdialytic ambulatory blood pressure monitoring was performed in 26 non-diabetic patients on long dialysis, in 22 patients on short dialysis, matched for the years they were on dialysis treatment, and during 24 h in 19 healthy volunteers. After full equilibration, 24 h after dialysis, echography of the inferior caval vein was performed to determine fluid state. Cardiac dimensions and stroke index were measured by echocardiography. A blood sample was drawn for the determination of electrolytes and vasoactive hormones. 73% of the patients on short dialysis were using antihypertensive medication in contrast to none of the patients on long dialysis. However, blood pressure was significantly lower in patients on long dialysis (115 ± 21/67 ± 11 mm Hg) when compared to patients on short dialysis (143 ± 26/81 ± 16 mm Hg). Indexed caval vein diameter, left ventricular diameter index, and atrial natriuretic peptide were not significantly different in patients on long dialysis compared to patients on short dialysis. Also the cardiac index was comparable in patients on long and short dialysis. However, the total peripheral resistance index was significantly lower in patients on long dialysis compared to the patients on short dialysis and normal controls. The left ventricular mass index was increased in both patients on long and short dialysis compared to controls. We conclude that patients on long dialysis have adequate blood pressure control that seems mainly to be caused by a low total peripheral resistance. These data also suggest that factors other than a lower fluid state contribute to the good blood pressure control in patients on long dialysis.

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Section: Discussionmentioning

confidence: 99%

Blood Pressure Control and Hemodynamic Changes in Patients on Long Time Dialysis Treatment

et al. 1998

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“…It is of great pathophysiological interest to study the hemodynamic effects of changes in sodium status without changes in fluid status and vice versa. Earlier studies that assessed the relationship between dialysate sodium and blood pressure failed to show a relation between increase in dialysate sodium and worsening interdialytic blood pressure control, despite an increase in interdialytic weight gain [58,59]. In contrast, in an earlier study in which lowering of the dialysate sodium concentration was combined with a reduction in dietary salt intake without any change in 'dry-weight', blood pressure control in hypertensive dialysis patients improved significantly [60].…”

Section: Is There a Role For Salt Alone?mentioning

confidence: 96%

Salt and Hypertension in End-Stage Renal Disease

1998

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Salt and fluid overload play an important role in the pathogenesis of hypertension in patients with end-stage renal disease. However, in the individual patient, the relation between salt loading and blood pressure response is variable and appears to be influenced by various neurohumoral regulatory mechanisms. This may also have implications for the pathogenesis of structural cardiovascular abnormalities in patients with end-stage renal disease.

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“…The level of Na being high or low in the dialysate directly affects the level of Na in patients. It is recommended, therefore, that the Na level in the dialysate is kept between 139 and 144 mEq/L to prevent development of hyponatremia or hypernatremia in patients (Henrich et al, 1982, Swartz et al, 1982. An Na modeling is made today in some patient groups (high level of Na at the beginning of dialysis and low levels in later hours).…”

Section: Impaired Sodium Balancesmentioning

confidence: 99%