Sodium Prescription in the Prevention of Intradialytic Hypotension: New Insights into an Old Concept.

Abstract

BACKGROUND Sodium prescription in patients with intradialytic hypotension remains a challenge for the attending nephrologist, as it increases dialysate conductivity in hypotension-prone patients, thereby adding to dietary sodium levels. METHODS New sodium prescription strategies are now available, including the use of a mathematical model to compute the sodium mass to be removed during dialysis as a physiological controller. RESULTS This review describes the sodium load of patients with end-stage renal disease on chronic hemodialysis (HD) and discusses 2 strategies to remove excess sodium in patients prone to intradialytic hypotension, namely, Profiled HD and the hemodiafiltration Aequilibrium System. CONCLUSION The Profiled HD and Aequilibrium System trial both proved effective in counteracting intradialytic hypotension.

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