title: Effects of lowering dialysate sodium on flow-mediated dilatation in patients with chronic kidney disease.
abstract: OBJECTIVE
  This study examined the effects of low dialysate sodium on endothelial dysfunction (ED) as measured by flow-mediated dilatation (FMD) of brachial artery in haemodialysis (HD) patients.
  
  
  METHODS
  Thirty HD patients (17 men; mean age: 48.4 ± 17.8 years) were studied. Subjects underwent two consecutive 6-week HD periods. Dialysate sodium was 143 mEq/L in the first period (standard Na HD) and 137 mEq/L in the second period (low Na HD). After each period, we performed FMD, echocardiographic evaluation and 24-h ambulatory blood pressure monitoring (ABPM). Interdialytic weight gain (IDWG), levels of pre- and post-dialysis blood pressure (BP), and dialysis-related symptoms were monitored during the study.
  
  
  RESULTS
  Per cent FMD was significantly greater (P < 0.05) after low Na HD (9.3 ± 6.2) compared with standard Na HD (5.7 ± 6.2). IDWG was significantly lower during low Na HD (2.35 ± 0.86 kg versus 2.71 ± 0.89 kg; P < 0.001). BP control was improved during low Na HD, as assessed by ABPM (128.2/77.5 mmHg versus 132.4/80.8 mmHg). Dialysis-related symptoms were more frequent during low Na HD (P < 0.05). There was no change in left ventricular mass after reducing dialysate sodium.
  
  
  CONCLUSIONS
  Reducing dialysate sodium concentration reduced ED, and provided better control of IDWG and BP, but increased dialysis-related symptoms.
authors.affiliation: Department of Nephrology, Hacettepe University Medical Faculty, Ankara, Turkey. draysunaybal@yahoo.com
authors.forename: Aysun
authors.initials: A
authors.lastname: Aybal Kutlugün
authors.forename: Yunus
authors.initials: Y
authors.lastname: Erdem
authors.forename: Sercan
authors.initials: S
authors.lastname: Okutucu
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Enver
authors.initials: E
authors.lastname: Atalar
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arici
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects*; D001916:Brachial Artery / Q000187:drug effects*; D016022:Case-Control Studies; D004106:Dilatation; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006801:Humans; D007022:Hypotension / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D012964:Sodium / Q000097:blood / Q000494:pharmacology*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D015312:Hemodialysis Solutions; D012964:Sodium