Are Dialysate Sodium Levels Too High?
Article first published online: 9 APR 2012
© 2012 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 25, Issue 3, pages 277–283, May/June 2012
How to Cite
Marshall, M. R. and Dunlop, J. L. (2012), Are Dialysate Sodium Levels Too High?. Seminars in Dialysis, 25: 277–283. doi: 10.1111/j.1525-139X.2012.01072.x
- Issue published online: 20 MAY 2012
- Article first published online: 9 APR 2012
Universal lower dialysate [Na+] is often advocated as a means of improving the dire cardiovascular plight of our dialysis patients. However, there is evidence associating lower dialysate [Na+] and increased morbidity and mortality especially in frailer patients, probably as a result of more frequent intra-dialytic hypotension. In this editorial, we summarize arguments for and against lower dialysate [Na+], and provide recommendations around selecting the most appropriate dialysate [Na+] for specific clinical subsets that may benefit from manipulation of salt and water balance. The lack of overall clarity on relative benefits and risks of lower dialysate [Na+] does not support the case for empirical “across the board” change, and experimental testing in clinical trials is required to determine safe and effective use.