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Kidney Week

Abstract: FR-PO443

Impact of Hemodialysis on the Concentrations of Sodium and Potassium During Infusion of Sodium Thiosulfate Using an In Vitro Hemodialysis Model

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Nigwekar, Sagar U., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Pai, Amy Barton, University of Michigan, Ann Arbor, Michigan, United States
  • Mueller, Bruce A., University of Michigan, Ann Arbor, Michigan, United States
  • Costello, Gabrielle M., University of Michigan, Ann Arbor, Michigan, United States
  • Dean, Michael C., University of Michigan, Ann Arbor, Michigan, United States
  • Sherman, Craig, Hope Pharmaceuticals, Scottsdale, Arizona, United States
Background

The purpose of this study was to evaluate the impact of hemodialysis on the concentrations of sodium and potassium in the blood when a 25 g dose of sodium thiosulfate injection is infused over 60 minutes in combination with hemodialysis.

Methods

Sodium thiosulfate (25 g) was prepared by diluting 100 mL of 250 mg/mL Sodium Thiosulfate Injection with 800 mL of 5% dextrose. This was added to the circulating blood surrogate solution at a rate of 15 mL/minute using an infusion pump of an in vitro model of dialysis machine [Figure]. Serial samples were collected before the administration of the sodium thiosulfate solution, after 15 minutes, 30 minutes, and 60 minutes of infusion from pre-and post-dialyzer ports in both the dialysate circuit and the extracorporeal circuit.

Results

The concentration of sodium thiosulfate in pre-dialyzer and post-dialyzer samples of the circulating blood surrogate solution peaked at 30 minutes and 15 minutes, respectively and then remained relatively unchanged during the remainder of the infusion. Mean sodium concentrations (mEq/L) in the circulating blood surrogate solution collected after exposure to a dialyzer were 103.2 ± 12.2, 114.2 ± 18.8, 117.2 ± 7.5, 93.5 ± 5.9 at 0, 15, 30, and 60 minutes, respectively (p=0.248). Mean potassium concentrations (mEq/L) in the circulating blood surrogate solution collected after exposure to a dialyzer were 1.4 ± 0.3, 1.6 ± 0.3, 1.5 ± 0.1, 1.2 ± 0.1 at 0, 15, 30, and 60 minutes, respectively (p=0.365). Sodium and potassium concentrations in dialysate increased marginally after exposure to the dialyzer.

Conclusion

Our study demonstrates that neither potassium nor sodium accumulated in a circulating blood surrogate solution when a dose of sodium thiosulfate was infused in conjunction with hemodialysis.

Figure. Schematic diagram of in vitro hemodialysis model used in this study