None listed
Conditions
Brief summary
A rise in systolic blood pressure at the end of dialysis treatment compared to the beginning is associated with increased mortality during follow-up. This observational study aimed to see whether adjusting the dialysate sodium such that it matched the patient sodium helped to prevent significant rises in blood pressure during treatment, without causing undesirable falls in blood pressure. Matching of patient and dialysate sodium will be accomplished by adjusting the dialysate sodium so that the blood sodium concentration leaving the patient to go through the dialyser is the same as that re-entering the patient after its passage through the dialyser. Our hypothesis is that individualising the dialysate sodium in this way will reduce blood pressure problems during the dialysis treatment and may improve thirst.
Interventions
Adjustment of dialysate sodium concentration during haemodialysis within the range 135 to 145mmol/L to achieve net zero diffusive sodium flux as part of standard local clinical practice in patients receiving haemodialysis that experience intradialytic hypertension. The sodium flux will be determined by simultaneous sampling of pre and post dialyser blood, with pre and post dialyser dialysate sampling for confirmation. The initial dialysate sodium will be set at 140mmol/L and then adjusted iter
Adjustment of dialysate sodium concentration during haemodialysis within the range 135 to 145mmol/L to achieve net zero diffusive sodium flux as part of standard local clinical practice in patients receiving haemodialysis that experience intradialytic hypertension. The sodium flux will be determined by simultaneous sampling of pre and post dialyser blood, with pre and post dialyser dialysate sampling for confirmation. The initial dialysate sodium will be set at 140mmol/L and then adjusted iteratively at 3 consecutive dialysis sessions then continued indefinitely at that concentration. Patients will be observed for 2 months following the assessment of dialysate sodium flux, whether or not this assessment results in a change in dialysate sodium. Adjustment will be according to the formula New dialysate sodium = [Current dialysate Na] + ([Na]arterial - [Na]venous)
Sponsors
Richard Singer
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients with a median rise in BP of > 10 mmHg during dialysis over the preceding 2 week period AND an average pre-dialysis systolic BP >115 mmHg.
Exclusion criteria
Patients with an average pre-dialysis systolic BP <=115 mmHg over the preceding 2 weeks.
Outcome results
None listed