title: Effects of increasing diffusive sodium removal on blood pressure control in hemodialysis patients with optimal dry weight.
abstract: BACKGROUND
  Sodium, apart from volume, may have an independent effect on blood pressure (BP) regulation.
  
  
  METHODS
  Sixteen hypertensive hemodialysis patients were enrolled, who have achieved their dry weight assessed by bioimpedance methods, with pre-dialysis plasma sodium levels slightly higher than the facility dialysate sodium concentration 138 mmol/l. After a 1-month period of dialysis with standard dialysate sodium concentration of 138 mmol/l, the patients were followed up for a 4-month period with dialysate sodium set at 136 mmol/l.
  
  
  RESULTS
  Along with lowering dialysate sodium, there were significant decreases (-10 mm Hg and -6 mm Hg) in 44-hour ambulatory systolic and diastolic BP at 4 months. Interdialytic weight gain adjusted to the estimated dry weight mildly but significantly decreased (4.81 ± 1.51 vs. 4.36 ± 1.37%, p = 0.047). The post-dialysis volume parameters remained constant throughout the study period.
  
  
  CONCLUSIONS
  In selected hypertensive hemodialysis patients with optimal dry weight, increasing diffusive sodium removal resulted in significant BP decrease. It was probably due to a volume-independent effect.
authors.affiliation: Department of Nephrology, Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Yi-Lun
authors.initials: YL
authors.lastname: Zhou
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Li-Jie
authors.initials: LJ
authors.lastname: Ma
authors.forename: Fang
authors.initials: F
authors.lastname: Sun
authors.forename: Yang
authors.initials: Y
authors.lastname: Shen
authors.forename: Jing
authors.initials: J
authors.lastname: Huang
authors.forename: Tai-Gen
authors.initials: TG
authors.lastname: Cui
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001810:Blood Volume; D001834:Body Water; D001835:Body Weight; D002414:Cations, Monovalent; D017097:Electric Impedance; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology / Q000628:therapy*; D012964:Sodium / Q000097:blood*
chemical_list: D002414:Cations, Monovalent; D015312:Hemodialysis Solutions; D012964:Sodium