Sodium in Hemodialysis Fluid

Sanjay Kumar Agarwal

doi:10.3390/kidneydial1020020

Abstract

The principal aim of dialysis in relation to sodium is that dialysate sodium should not be low enough to cause intradialytic hypotension and cramps, and should not be high enough to cause interdialytic weight gain and hypertension. Dialysis sodium at 138 meq/L is supposed to be neutral and for most patients, this remains the standard sodium level for regular long-term dialysis. In my opinion, sodium should be changed temporarily from this level to 142 meq/L in selected patients only for a few dialysis sessions, where the cause of intradialytic hypotension is not obvious. In patients who regularly go into intradialytic hypotension and whose cause of intradialytic hypotension is unclear or cannot be corrected, sodium profiling should be used for maintenance dialysis. There is no consensus on the level of sodium, although I think 142 meq/L for the initial hour followed by a decrease to 138 meq/L in the last hour is sensible.

Highlights

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In patients who regularly go into intradialytic hypotension and whose cause of intradialytic hypotension is unclear or cannot be corrected, sodium profiling should be used for maintenance dialysis
There is no consensus on the level of sodium to be used in sodium profiling, I think 142 meq/L for the initial hour followed by a decrease to 138 meq/L in the last hour is a sensible approach

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Academic Editors: Manfred Hecking, Peter Kotanko and Jochen G. Received: 18 November 2021 Accepted: 29 November 2021 Published: 2 December 2021

Results

Conclusion