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Dialysate Sodium: Choosing the Optimal Hemodialysis Bath

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1 Dialysate Sodium: Choosing the Optimal Hemodialysis Bath
Jair Munoz Mendoza, MD, Rohini Arramreddy, MD, Brigitte Schiller, MD  American Journal of Kidney Diseases  Volume 66, Issue 4, Pages (October 2015) DOI: /j.ajkd Copyright © 2015 National Kidney Foundation, Inc. Terms and Conditions

2 Figure 1 (A) Dialysate sodium prescription in 1,084 thrice-weekly hemodialysis (HD) patients from a nonprofit dialysis provider (adapted from reference31). (B) Variation across 25 clinics of dialysate sodium prescription excluding the default of 140 mEq/L, in 524 thrice-weekly HD patients of a nonprofit dialysis provider (adapted from reference31). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2015 National Kidney Foundation, Inc. Terms and Conditions

3 Figure 2 Consequences of high sodium dialysate (Nad) concentration. Abbreviations: CV, cardiovascular; IDH, intradialytic hypotension; LVH, left ventricular hypertrophy; UFR, ultrafiltration rate. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2015 National Kidney Foundation, Inc. Terms and Conditions

4 Figure 3 Tool box of interventions to improve fluid management in hemodialysis (HD) patients. When choosing one of the tools, and especially when altering dialysate sodium concentration (Nad), hemodynamic response to the changes needs to be carefully monitored for risk-benefit assessment. Abbreviations: HTN, hypertension; IDWG, interdialytic weight gain; Na, plasma sodium. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2015 National Kidney Foundation, Inc. Terms and Conditions


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