Abstract: FR-PO0494
Standard Sodium, Variable Pressure: A Prospective Study on the Hemodynamic Effects of Dialysate Sodium in Hemodialysis
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Taran, Ferah, TC Saglik Bakanligi Sirnak Devlet Hastanesi, Sirnak, Turkey
- Sayarlioglu, Hayriye, Ondokuz Mayis Universitesi Tip Fakultesi, Samsun, Turkey
Background
Blood pressure variability (BPV) is a critical concern for hemodialysis patients and linked to adverse cardiovascular outcomes. Adjusting dialysate sodium (dNa) is a key strategy for managing blood pressure, influencing intradialytic hemodynamics and interdialytic control. The standard 138-140 mEq/L dNa is usually close to the patient's serum, but responses vary with factors like sodium intake, renal function, and ultrafiltration. We aimed to evaluate the impact of 138 vs. 140 mEq/L dNa on pre- and intradialytic BPV in hemodialysis patients.
Methods
This prospective study included 10 patients on thrice-weekly maintenance hemodialysis for ≥3 months at a single centre. Baseline data included demographics, dialysis vintage, comorbidities, medications, and predialysis blood pressures. The protocol had a month control phase at 140 mEq/L dialysate sodium, followed by a month intervention at 138 mEq/L. Blood pressures were recorded pre-, mid-, and post-dialysis, and intradialytic hypotension events were tracked. Interdialytic weight gain, intradialytic weight loss, and inadequate ultrafiltration were monitored as surrogates for volume status.
Results
Ten patients completed all sessions in both sodium periods. Although patient-level fluctuations were observed—most notably in Patient 5 with a systolic blood pressure standard deviation of 41.85 mmHg during the 138 mEq/L period—no statistically significant difference was found between sodium concentrations in terms of systolic (Z = –0.36, p = .721) or diastolic (Z = –0.20, p = .838) blood pressure variability.
Conclusion
In this small cohort of chronic HD patients, altering dialysate sodium concentration from 140 to 138 mEq/L did not result in significant changes in predialysis blood pressure variability.
Effect of Dialysate Sodium on Predialysis Blood Pressure Variability
| Variable | Mean ± SD (140 mEq/L) | Mean ± SD (138 mEq/L) | Z | p (2-tailed) |
| Predialysis Systolic BPV (mmHg) | 13.39 ± 5.19 | 16.65 ± 9.57 | -0.36 | 0.721 |
| Predialysis Diastolic BPV (mmHg) | 9.40 ± 3.78 | 9.21 ± 2.25 | -0.20 | 0.838 |
BPV: blood pressure variability