Sodium concentration in the dialysis solution - an important but neglected parameter of hemodialysis in patients with chronic renal failure
Abstract
Sodium ion, together with their accompanying anions determinant of body fluid osmolality, which controls changes in health overall fluid balance, on the one hand, the water intake in the diet and on the other hand its renal excretion. When kidney failure is dialysis removal of water taken but the mechanism of control fluid intake, changes in osmolarity is maintained even in this situation, and sodium balance is therefore essential.
She herself is yet determined how dietary salt intake and sodium balance during hemodialysis (HD). Selecting the concentration of sodium in the dialysis solution (cDNA), respectively. its difference from the plasma concentration (CPNa) therefore can significantly affect water intake in mezidialyzační time.
And yet, that is known for considerable inter-individual variance values CPNa, used by most dialysis centers for all patients the same amount of cDNA and the dietary advice to patients only recommended limiting the intake of fluids. This article analyzes the potential benefits of two basic ways of handling cDNA - its individualization at a constant value throughout the HD and the use of sodium profile (cDNA variables during one HD).
Based on literature data and own measurements concludes that the individualisation of cDNA is constant in the long run much better. The current "off-line" profiling cDNA regardless of the sophistication of the control algorithm brings with it the risk of a positive sodium balance and the associated negative impacts.
The dietary recommendations should be given emphasis to reduce salt intake instead of just recommending to restrict fluid intake.