title: Lowering dialysate sodium improves systemic oxidative stress in maintenance hemodialysis patients.
abstract: OBJECTIVE
  The purpose of the current prospective study was to evaluate the effects of low sodium dialysate on oxidative stress parameters, blood pressure (BP) and endothelial dysfunction in maintenance hemodialysis (HD) patients.
  
  
  METHODS
  After baseline measurements were taken, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Oxidative stress parameters and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low sodium dialysate. Interdialytic weight gain (IDWG) and pre- and post-dialysis BP were monitored during the study.
  
  
  RESULTS
  A total of 52 patients were enrolled and 41 patients completed the study. There was a significant reduction in systolic blood pressure at the end of the study [130.00 (90.00-190.00) vs. 120.00 (90.00-150.00), p < 0.001]. Similarly, there were significant improvements in IDWG [2670.00 (1670.00-4300.00) vs. 1986.00 (1099.00-3998.00), p < 0.001] and FMD % [7.26 (4.55-8.56) vs. 9.56 (6.55-12.05), p < 0.001]. Serum MDA levels (p < 0.001) were significantly decreased; serum SOD (p < 0.001) and GPx (p < 0.001) activities were significantly increased after low sodium HD compared to standard sodium HD.
  
  
  CONCLUSIONS
  Our data seem to suggest a potential role of 137 mEq/L sodium dialysate for improving hemodynamic status, endothelial function and reducing oxidative stress than 140 mEq/L sodium dialysate in maintenance HD patients.
authors.affiliation: Department of Nephrology, Uskudar State Hospital, 34000, Istanbul, Turkey.
authors.forename: Beyza
authors.initials: B
authors.lastname: Macunluoglu
authors.affiliation: Department of Cardiology, Yuzuncu Yil University, 65200, Van, Turkey.
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Gumrukcuoglu
authors.affiliation: Department of Nephrology, Fatih Sultan Mehmet Training Hospital, 34000, Istanbul, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Atakan
authors.affiliation: Department of Biochemistry, Yuzuncu Yil University, 65200, Van, Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Demir
authors.affiliation: Department of Biochemistry, Yuzuncu Yil University, 65200, Van, Turkey.
authors.forename: Hamit Hakan
authors.initials: HH
authors.lastname: Alp
authors.affiliation: Department of Cardiology, Yuzuncu Yil University, 65200, Van, Turkey.
authors.forename: Aytac
authors.initials: A
authors.lastname: Akyol
authors.affiliation: Department of Cardiology, Yuzuncu Yil University, 65200, Van, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Akdag
authors.affiliation: Department of Nephrology, Kartal Training Hospital, 34890, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: Department of Nephrology, Yeditepe University, 34890, Istanbul, Turkey.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Eren
authors.affiliation: Department of Biostatistics, Yuzuncu Yil University, 65000, Van, Turkey.
authors.forename: Sıddık
authors.initials: S
authors.lastname: Keskin
authors.affiliation: Department of Nephrology, Kartal Training Hospital, 34890, Istanbul, Turkey. elifaribakir@gmail.com.
authors.forename: Elif
authors.identifier: http://orcid.org/0000-0001-9208-7972
authors.initials: E
authors.lastname: Ari
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects*; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D015312:Hemodialysis Solutions / Q000494:pharmacology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D018384:Oxidative Stress / Q000187:drug effects*; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012964:Sodium / Q000097:blood / Q000494:pharmacology; D013223:Statistics as Topic
chemical_list: D015312:Hemodialysis Solutions; D012964:Sodium
keywords: Dialysate sodium; Endothelial dysfunction; Hemodialysis; Oxidative stress