title: [Advantage of a high-sodium hemodialysis solution: theoretical bases].
abstract: In hemodialysis, an excessive oversimplification leads to confuse the transfer direction of a given solute (patient towards dialysate or dialysate towards patient) and the direction of transmembranar concentration gradient. Applied to sodium, this confusion leads to the usual iso- or hypotonic dialysate use, in order to eliminate the patient's sodium overload. We show here how the use of a high sodium dialysate allows the elimination of the sodium overload and makes the free water clearance (approached by the Na-free water clearance) positive, which is the necessary condition to restore an hydro-electrolytic equilibrium near from the normal. That allows a disappearance of hypovolemic symptoms during hemodialysis, a better general condition and a possible increase of water intake between sessions.
mesh_terms: D006801:Humans; D008657:Metabolic Clearance Rate; D009994:Osmolar Concentration; D006435:Renal Dialysis / Q000379:methods*; D012964:Sodium / Q000008:administration & dosage*; D014462:Ultrafiltration; D014867:Water / Q000378:metabolism; D014882:Water-Electrolyte Balance
chemical_list: D014867:Water; D012964:Sodium
vernacular_title: Intérêt d'un bain d'hémodialyse riche en sodium: fondements théoriques.