title: Effects of lowered dialysate sodium on left ventricle function and brain natriuretic peptide in maintenance of hemodialysis patients.
abstract: BACKGROUND
  Impaired diastolic flow is characterized by decreased left ventricular (LV) filling diastole, abnormal LV distensibility, or delayed relaxation. B-Type natriuretic peptide (BNP) is an indicator of various cardiovascular diseases and body volume status. The aim of this study was to determine whether the lowering of dialysate sodium (Na) levels is effective on LV systolic and diastolic parameters and BNP in the maintenance of hemodialysis patients.
  
  
  METHODS
  The study included 49 chronic hemodialysis patients. Left atrium (LA) diameter and LV ejection fraction, LV systolic and diastolic diameter, deceleration time (DT), pulmonary artery pressure (PAP), inferior vena cava diameter (IVCD), early diastolic transmitral flow ( E) and late diastolic transmitral flow ( A) velocities, E/ A ratio, isovolumic relaxation time, peak early diastolic velocity ( E'), late diastolic velocity ( A') of tissue Doppler mitral annulus, and flow propagation velocity of mitral inflow ( Vp) were measured before and 6 months after hemodialysis with low Na dialysate.
  
  
  RESULTS
  Six months after low Na hemodialysis, a decrease was observed in echocardiographic parameters such as PAP and IVCD ( p < 0.05, p < 0.001, and p < 0.001, respectively). However, a significant difference was not observed in LA diameter. In LV diastolic measurement of E and A waves, E/ A ratio, DT, Vp, septal E' and A', and lateral E' and A' exhibited significant improvement by low Na HD. BNP level was significantly reduced ( p < 0.001).
  
  
  CONCLUSIONS
  Lowered dialysate Na concentration improves PAP, IVCD, and LV diastolic properties assessed by mitral inflow filling, tissue Doppler velocity, and mitral inflow velocity propagation.
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Akyol
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Akdag
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Asker
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: H A
authors.initials: HA
authors.lastname: Gumrukcuoglu
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Duz
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: K C
authors.initials: KC
authors.lastname: Demirel
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Ozturk
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yaman
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Simsek
authors.affiliation: 1 Department of Cardiology, Yuzuncu Yil University, Van, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Tuncer
authors.affiliation: 2 Department of Nephrology, Yuzuncu Yil University, Van, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Begenik
mesh_terms: D000328:Adult; D000368:Aged; D015314:Dialysis Solutions; D004452:Echocardiography; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D006435:Renal Dialysis; D016277:Ventricular Function, Left
chemical_list: D015314:Dialysis Solutions; D020097:Natriuretic Peptide, Brain
keywords: Dialysate sodium; brain natriuretic peptide; left ventricle function; maintenance hemodialysis