title: Effects of lowering dialysate sodium on carotid artery atherosclerosis and endothelial dysfunction in maintenance hemodialysis patients.
abstract: OBJECTIVE
  Our aim in this study was to examine the effects of low-sodium dialysate on carotid artery atherosclerosis, endothelial dysfunction, and blood pressure (BP) in maintenance hemodialysis (HD) patients.
  
  
  METHODS
  After baseline measurements were obtained, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Carotid artery intima-media thickness (CIMT) and flow-mediated dilatation (FMD%) were measured before and after 6 months of HD with low-sodium dialysate. Interdialytic weight gain (IDWG), pre- and post-dialysis BP, and dialysis-related symptoms were monitored during the study.
  
  
  RESULTS
  Fifty-two patients were enrolled, and 41 patients completed the study. Twenty-one patients had hypertension and were receiving antihypertensive medications. The average number of antihypertensive drugs per patient was 1.9±0.8. There was no significant reduction in BP at the end of the study, but the average number of antihypertensive drugs was reduced to 1.2±0.4 (P<0.001). There were significant improvements in CIMT (P=0.003) and FMD (P<0.001) with low-sodium HD. The IDWG decreased significantly during the low-sodium dialysate treatment (P<0.001). However, hypotensive episodes and cramps were more frequent during the study period.
  
  
  CONCLUSIONS
  Our study demonstrated that the lowering of dialysate sodium concentration reduced CIMT, improved FMD, and provided better control of IDWG and BP, but increased the incidence of dialysis-related symptoms.
authors.affiliation: Cardiology Department, Faculty of Medicine, Yuzuncu Yil University, and Nephrology Department, Van High Education and Research Hospital, Van, Turkey. hasanaliq80@yahoo.com
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Gümrükçüoğlu
authors.forename: Elif
authors.initials: E
authors.lastname: Arı
authors.forename: Aytaç
authors.initials: A
authors.lastname: Akyol
authors.forename: Serkan
authors.initials: S
authors.lastname: Akdağ
authors.forename: Hakkı
authors.initials: H
authors.lastname: Simşek
authors.forename: Musa
authors.initials: M
authors.lastname: Sahin
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Güneş
authors.forename: Mustafa
authors.initials: M
authors.lastname: Tuncer
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D002340:Carotid Artery Diseases / Q000517:prevention & control*; D059168:Carotid Intima-Media Thickness; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012964:Sodium / Q000008:administration & dosage* / Q000494:pharmacology*
chemical_list: D015312:Hemodialysis Solutions; D012964:Sodium