The Impact of Low Sodium Dialysate on Different Echocardiographic Parameters in Prevalent Hemodialysis Patients

Abstract

Abstract Background ESRD affects about 15% of adult population, leading to increased morbidity and mortality. Historically, hemodialysis treatments used low dialysate sodium (D-NA) in the range of 120 mEq/L to enable elimination of excess sodium from the body. Over time, higher D-Na (∼140 mEq/L) was used to improve hemodynamic stability during dialysis. Aim of the Work To determine the impact of decreased dialysate Na on cardiac functions and different echocardiographic parameters in prevalent heamodialysis patients. Patients and Methods A Prospective study was conducted, consisted of 45 patients on regular Hemodialysis at Rod Elfarag Hospital dialysis unit for 6 months. Results In the current study, there was high statistically significant difference between baseline lab investigation and after 6 months lab investigation as regard Hemoglobin, WBCs, Platelets, Ht, URR, serum albumin, Ca, Na, Phosphorus and BNP (p < 0.001). We found that there was high statistically significant difference between baseline ECG and after 6 months ECG as regard PR interval, QRS duration and QT interval (p < 0.001). There was high statistically significant difference between baseline Echocardiography and after 6 months Echocardiography as regard left atrium diameter, EF%, Diastolic BP and Systolic BP (p < 0.001). Conclusion A reduction of the dialysate sodium concentration based on the predialysis sodium levels of the patients could reduce the SBP and decrease the volume load on heart. Within this short period, DBP could not be lowered. The effect of this approach should be studied in broad and lengthy series.