title: Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis.
abstract: Optimal dialysate sodium (dNa) is unknown, with both higher and lower values suggested in adult studies to improve outcomes. Similar studies in pediatric hemodialysis (HD) population are missing. This is the first report of the effect of two constant dNa concentrations in pediatric patients on chronic HD. 480 standard HD sessions and interdialytic periods were studied in 5 patients (age 4-17 years, weight 20.8-66 kg) during a period of 6-11 months per patient. dNa was 140 mEq/L during the first half, and 138 mEq/L during the second half of the study period for each patient. Lowering dNa was associated with improved preHD hypertension, decreased interdialytic weight gain, decreased need for ultrafiltration, lower sodium gradient and was well tolerated despite lack of concordance with predialysis sNa, that was variable. Further studies are needed to verify our findings and to investigate if an even lower dNa may be more beneficial in the pediatric HD population.
authors.affiliation: Department of Pediatrics, Yale University, Pediatric Nephrology, New Haven, Connecticut, USA.
authors.forename: Olivera
authors.initials: O
authors.lastname: Marsenic
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Anderson
authors.affiliation: Department of Pediatrics, Yale University, Pediatric Critical Care, New Haven, Connecticut, USA.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Couloures
authors.affiliation: Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: Woo S
authors.initials: WS
authors.lastname: Hong
authors.affiliation: Department of Pediatrics, Yale University, Pediatric Cardiology, New Haven, Connecticut, USA.
authors.forename: E
authors.initials: E
authors.lastname: Kevin Hall
authors.affiliation: Department of Internal Medicine, Yale University, Nephrology, New Haven, Connecticut, USA.
authors.forename: Neera
authors.initials: N
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015314:Dialysis Solutions / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012964:Sodium / Q000378:metabolism*
chemical_list: D015314:Dialysis Solutions; D012964:Sodium
keywords: Dialysate sodium; hypertension; interdialytic weight gain; pediatric hemodialysis; ultrafiltration