Abstract
The optimal dialysate sodium concentration for chronic hemodialysis patients remains controversial. Conflicting data from small observational studies and large cohort study data have not convinced nephrologists to choose either a high or low sodium dialysate. Despite a lack of evidence, I would prescribe individualized dialysate sodium concentrations for patients with a risk of hypertension or volume overload, aligning the dialysate sodium concentration with patients’ predialysis serum sodium level. The concentration of dialysate sodium would usually be 0–2 mEq/L below the patient’s serum sodium concentration. I believe that this strategy would help improve hypertension, intradialytic weight gain, cardiac outcomes, and deliver precision medicine.
Highlights
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
Specific Aim: “You are being put in charge as the Medical Director of a newly built dialysis clinic in your country
The patients will be able to adjust their salt and fluid intake to reach their own natremic set point [4]. It is easier for the dialysis unit to routinely start a new patient, with a dialysate sodium concentration of 138 mEq/L
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. How to Adjust the Sodium Concentration in Dialysate Individually and Practically? I would advocate three steps in prescribing the dialysate sodium concentration for patients in my dialysis clinic.
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