title: The benefits and side effects of ramped hypertonic sodium dialysis.
abstract: The effectiveness of ramped hypertonic sodium dialysis (RHSD) is controversial because of the prevalence of side effects (weight gain and hypertension). Standard dialysis (SD) was therefore compared with RHSD in a double-blind controlled crossover trial. Eleven patients who suffered from symptoms attributable to water shifts from extracellular fluid to intracellular fluid (headaches or hangover) or extracellular-fluid volume contraction (cramps or lightheadedness) and five asymptomatic patients were enrolled in the study. RHSD was individually tailored to each patient (to minimize thirst) during a 2-wk run-in period. Patients then received RHSD and SD for a period of 3 wk in randomized sequence. Outcome measures were both objective and subjective ratings on questionnaires. Significant differences were found between the two treatments, with RHSD improving specific problems (70% of lightheadedness/cramps, 100% of headaches/hangover) versus SD. Weight gain and hypertension were not different between the two treatments despite increased thirst sensation reported by 14/16.94% of patients preferred RHSD. Long-term studies in 20 different patients demonstrated the lack of increase in blood pressure or weight gain after 3 and 6 months of therapy.
authors.affiliation: Division of Nephrology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Levin
authors.forename: M B
authors.initials: MB
authors.lastname: Goldstein
mesh_terms: D001794:Blood Pressure; D015314:Dialysis Solutions / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006982:Hypertonic Solutions / Q000009:adverse effects; D008297:Male; D010807:Physical Endurance / Q000187:drug effects; D006435:Renal Dialysis; D012189:Retrospective Studies; D012964:Sodium / Q000009:adverse effects; D013894:Thirst / Q000187:drug effects; D015430:Weight Gain
chemical_list: D015314:Dialysis Solutions; D006982:Hypertonic Solutions; D012964:Sodium