title: Effects of Sodium Concentration and Dialysate Temperature Changes on Blood Pressure in Hemodialysis Patients: A Randomized, Triple-Blind Crossover Clinical Trial.
abstract: The present study investigated the effects of different temperatures and sodium dialysate concentration on blood pressure in hemodialysis patients. Following Williams' design, hemodialysis patients were randomly assigned into four dialysis modes. Dialysate temperature was set at 37°C for modes A and C and, 35°C for modes B and D. Sodium concentration was set at 138 mmol/L in modes A and B, while it changed from 150 mmol/L to 138 mmol/L in modes C and D. Using analysis of variance for repeated measures, the mean values of systolic and diastolic blood pressure were investigated. The mean values of systolic and diastolic blood pressure in modes C and D had a significant difference with the values in mode A. The mean values of systolic and diastolic blood pressure in patients dialyzed with mode B had a significant difference with the values in those dialyzed with mode D. Moreover, there were significant differences in the incidence of hypotension between A and other modes and between B and modes C and D, but this difference was not significant between modes C and D. In order to reduce intradialytic blood pressure fluctuations and hypotension, the nursing staff are recommended to gradually reduce dialysate sodium concentration.
authors.affiliation: Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ebrahimi
authors.affiliation: Department of Nursing and Midwifery, Islamic Azad University of Tehran, Tehran, Iran.
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Safavi
authors.affiliation: Damghan Vellayate Hospital, Semnan University of Medical Sciences, Semnan, Iran.
authors.forename: Marzieh Hossein
authors.initials: MH
authors.lastname: Saeidi
authors.affiliation: Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Emamian
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D018592:Cross-Over Studies; D015314:Dialysis Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012964:Sodium / Q000008:administration & dosage / Q000009:adverse effects*; D013696:Temperature
chemical_list: D015314:Dialysis Solutions; D012964:Sodium
keywords: Blood pressure; Dialysate sodium; Dialysate temperature; Dialysis; Renal failure