Optimal dialysate sodium-what is the evidence?

Semin Dial. 2014 Mar;27(2):128-34. doi: 10.1111/sdi.12182. Epub 2014 Jan 23.

Abstract

Oligo-anuric patients with end-stage kidney disease are dependent on hemodialysis to achieve and maintain the desired goal of euvolemia. The dialysis prescription, in addition to sodium and fluid restriction, is therefore a critically important factor in the care of hemodialysis patients. Various dialysate sodium concentrations have been favored throughout the history of dialysis, but the "optimal" concentration remains unclear. In this manuscript, we examine the historical context of changes to the dialysate sodium prescription, review the evidence of its associated effects, discuss 'individualization' of dialysate sodium, and highlight the need for definitive trials that are powered for important clinical outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Algorithms
  • Dialysis Solutions / chemistry*
  • Humans
  • Renal Dialysis*
  • Sodium / administration & dosage
  • Sodium / analysis*

Substances

  • Dialysis Solutions
  • Sodium