The Impact of the Gradual Reduction of Dialysate Sodium on Occurrence of the Hypotension and Plasma Sodium Level in Hemodialysis Patients

Background: Dialysis is the most common method of caring end-stagekidney disease, but it has some complications despite its severaladvantages. The aim of study was to investigate the impact of thegradual reduction of dialysate sodium on occurrence of thehypotension and plasma sodium in hemodialysis patients.Methods: ۵۶ hemodialysis patients participated in this randomizedtriple-blind crossover clinical trial. The patients were randomlydivided into two groups of A and B. The routine method (SodiumDialysis solution) was performed on group A, whereas the gradualreduction of sodium dialysis fluid was given to group B for threesessions. These dialysis methods were again implemented threesessions, after one week of routine dialysis (wash out). The routinemethod (Sodium Dialysis solution) was performed on group B, and thegradual reduction of sodium dialysis fluid was performed on group A,for three sessions. Patients' blood pressure was measured threeseparate times: ۱۵ minutes before dialysis, during dialysis (first,second, third and fourth hours of dialysis) and ۱۵ minutes after of it.Moreover, Patients' sodium level was also measured before and afterthe intervention. In this way, the descriptive statistics and inferentialstatistics (repeated measure analysis of covariance) were utilized toimplement data analysis.Results: In the case of routine method, the percentages of theprevalence of hypotension in above mentioned different hours weredeclared ۶.۲%, ۲۶.۶%, ۴۴.۵%, ۳۲.۸%, respectively. On the other hand,in the case of the gradual reduction of sodium dialysis fluid, thesecorresponding percentages were cleared ۲.۳%, ۱.۷%, ۵.۳۱%, ۴۴.۴۶%,respectively. The mean differences of plasma sodium before and afterdialysis in the mentioned methods were obtained as ۰.۵۸ in the case ofroutine method, whereas it is ۲.۳۶ in the case of gradual reduction ofsodium dialysis fluid method. In this research, there was no significantdifference between the rate of hypotension and plasma sodium in thegradual reduction of sodium dialysis fluid by the routine method under۸۰% powers.Conclusions: The experimental results revealed that a gradualreduction of the sodium dialysis fluid did not play a significant role inthe reduction of blood pressure during dialysis and plasma sodium inhemodialysis patients. However, either confirmation or rejection of thisissue will require further studies and resolving the limitations.

Keywords:

Sodium dialysis fluid , Hypotension , Plasma Sodium , Hemodialysis