title: Association between pre hemodialysis serum sodium concentration and blood pressure: results from a retrospective analysis from the international monitoring dialysis outcomes (MONDO) initiative.
abstract: A recent study from the United Kingdom indicates an association between pre hemodialysis (HD) serum sodium (SNa(+)) and systolic and diastolic blood pressure (SBP and DBP) in chronic HD patients. We extend this analysis to an international cohort of incident HD patients. The Monitoring Dialysis Outcomes initiative encompasses patients from 41 countries. Over 2 years monthly pre-HD SNa(+) levels were used as predictors of pre-HD SBP and DBP in a linear mixed model (LMM) adjusted for age, gender, interdialytic weight gain, diabetes, serum albumin and calcium. Similar models were constructed with DBP as outcome. Analyses were carried out stratified by continent (North and South America; Europe and Asia). LMMs were also constructed for the entire observation period of 2 years, and separately the first and the second year after HD initiation. We studied 17 050 incident patients and found SNa(+) to have a significant slope estimate in the LMM predicting pre-HD SBP and DBP (ranging from 0.22 to 0.29 and 0.10 to 0.21 mm Hg per mEq l(-1), respectively, between the continents). The findings were similar in subsets of SBP and SNa(+) tertiles, and separately analyzed for the first and second year. Our analysis shows an independent association between SNa, SBP and DBP in a large intercontinental database, indicating that this relation is a profound biological phenomenon in incident and prevalent HD patients, generalizable to an international level and independent of SBP and DBP magnitude.
authors.affiliation: Research Division, Renal Research Institute, New York, NY, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Raimann
authors.affiliation: Fresenius Medical Care, Europe, Middle East, Africa, Latin America.
authors.forename: B
authors.initials: B
authors.lastname: Canaud
authors.affiliation: Fresenius Medical Care Asia-Pacific, Hong Kong, People's Republic of China.
authors.forename: M
authors.initials: M
authors.lastname: Etter
authors.affiliation: Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: J P
authors.initials: JP
authors.lastname: Kooman
authors.affiliation: Research Division, Renal Research Institute, New York, NY, USA.
authors.forename: N W
authors.initials: NW
authors.lastname: Levin
authors.affiliation: Fresenius Medical Care, Europe, Middle East, Africa, Latin America.
authors.forename: D
authors.initials: D
authors.lastname: Marcelli
authors.affiliation: Fresenius Medical Care, Buenos Aires, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Marelli
authors.affiliation: Imperial College, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Power
authors.affiliation: Imperial College, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Duncan
authors.affiliation: Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: F M
authors.initials: FM
authors.lastname: van der Sande
authors.affiliation: Fresenius Medical Care, Europe, Middle East, Africa, Latin America.
authors.forename: P
authors.initials: P
authors.lastname: Carioni
authors.affiliation: Research Division, Renal Research Institute, New York, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Thijssen
authors.affiliation: Fresenius Medical Care Asia-Pacific, Hong Kong, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Xu
authors.affiliation: Research Division, Renal Research Institute, New York, NY, USA.|Fresenius Medical Care North America, Waltham, MA, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Usvyat
authors.affiliation: University of California Santa Barbara, Santa Barbara, CA, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Research Division, Renal Research Institute, New York, NY, USA.|Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: P
authors.initials: P
authors.lastname: Kotanko
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D006435:Renal Dialysis; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood*; D013020:South America / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D012964:Sodium