Indian Journal of Nephrology Home 

ORIGINAL ARTICLE
[View FULLTEXT] [Download PDF]
Year : 2020  |  Volume : 30  |  Issue : 1  |  Page : 3--7

Effects of individualized dialysate sodium prescription in hemodialysis – Results from a prospective interventional trial

Radhika C Radhakrishnan1, Santosh Varughese2, Abitha Chandran2, Shibu Jacob2, Vinoi G David2, Suceena Alexander2, Anjali Mohapatra2, Anna T Valson2, Basu Gopal2, C Palani2, Arun Jose3, B Antonisamy4, V Tamilarasi2 
1 Department of Nephrology, Christian Medical College, (Current Affiliation: Department of Pediatric Nephrology, Government Medical College, Thiruvananthapuram, Kerala), India
2 Department of Nephrology, Christian Medical College, (Current Affiliation: Department of Renal Medicine, The Alfred Hospital, Melbourne, Australia), Australia
3 Department of Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India
4 Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Radhika C Radhakrishnan
Department of Pediatric Nephrology, Government Medical College, Thiruvananthapuram - 695 011, Kerala
India

Introduction: Individualized dialysate sodium prescription does affect weight gain, blood pressure (BP), and intradialytic complications. A prospective interventional trial (Dialysate Individualised Sodium (DISO) trial) was conducted to study this issue in Indian patients. Methods: Forty patients on thrice-weekly maintenance hemodialysis (HD) for at least 6 weeks were enrolled. The study was performed in two different phases. In the first phase, 12 consecutive HD sessions were done with a standard dialysate sodium concentration of 140 mEq/L. In the second phase, 12 consecutive HD sessions were done with dialysate sodium concentration set to individualized value (mean of pre-HD sodium concentration multiplied by Donnan coefficient of 0.95). Differences in pre- and post-HD sodium, interdialytic weight gain (IDWG), pre- and post-HD BP, thirst scores, and intradialytic adverse events during both phases were assessed. Results: The mean age of patients was 45.65 years (24 males, 16 females). The mean serum pre-HD sodium level was 138.7 ± 1.7 meq/L in the standard phase and 138.2 ± 2.6meq/L in the individualized phase (P = 0.229). In the standard phase, the mean IDWG was 2.64 ± 1.56 kg and 2.13 ± 0.99 kg in the individualized phase (P = 0.008). The mean pre-HD systolic BP was 138 ± 18 mmHg and 134 ± 17 mmHg in the standard and individualized phases (P = 0.008). There was no difference in intradialytic symptoms, hypotensive episodes or requirement of interventions. Hypertension episodes occurred at a mean value of 2.2 and 1.2 in the standard and individualized phases, respectively (P = 0.010). Conclusion: The use of individualized dialysate sodium level is safe and results in lower IDWG, pre-HD systolic BP, and intradialytic hypertension in patients on HD.

How to cite this article:
Radhakrishnan RC, Varughese S, Chandran A, Jacob S, David VG, Alexander S, Mohapatra A, Valson AT, Gopal B, Palani C, Jose A, Antonisamy B, Tamilarasi V. Effects of individualized dialysate sodium prescription in hemodialysis – Results from a prospective interventional trial.Indian J Nephrol 2020;30:3-7

How to cite this URL:
Radhakrishnan RC, Varughese S, Chandran A, Jacob S, David VG, Alexander S, Mohapatra A, Valson AT, Gopal B, Palani C, Jose A, Antonisamy B, Tamilarasi V. Effects of individualized dialysate sodium prescription in hemodialysis – Results from a prospective interventional trial. Indian J Nephrol [serial online] 2020 [cited 2020 Jun 3 ];30:3-7
Available from: http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2020;volume=30;issue=1;spage=3;epage=7;aulast=Radhakrishnan;type=0