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KMID : 0359920130320020062
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Korean Journal of Nephrology
2013 Volume.32 No. 2 p.62 ~ p.65
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Postdialysis serum sodium changes and systolic blood pressure in patients undergoing online hemodiafi ltration and high-fl ux hemodialysis
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Hwang Kyu-Sig
Choi Eun-Young
Park Joon-Sung
Lee Chang-Hwa
Kang Chong-Myung
Kim Gheun-Ho
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Abstract
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Background: Because hemodiafiltration (HDF) involves large amounts of ultra-filtration and substitution fluid infusion, its effects on serum electrolytes may be different from those of hemodialysis (HD). Serum sodium and blood pressures were compared between patients undergoing online HDF and high-flux HD (HFHD). Methods: Thirty-two of 101 patients on HFHD switched voluntarily to online HDF. Their pre- and postdialysis serum measurements were compared with those of the remaining 69 HFHD patients. Results: Online HDF patients had lower pre- and postdialysis systolic blood pressures (SBPs) than HFHD patients (predialysis, 136721 vs. 145719 mmHg, Po0.05; postdialysis, 129722 vs. 142725 mmHg, Po0.05). Pre- and postdialysis serum sodium concentrations were not significantly different between online HDF and HFHD(predialysis, 13872 vs. 13773 mEq/L; postdialysis, 13472 vs. 13472mEq/L). However, the change in serum sodium concentration after dialysis was greater in online HDF than HFHD patients (?3.772.2 vs. ?2.572.8 mEq/L, Po0.05). The change in serum sodium concentrationwas correlated with postdialysis SBP (r ¼ 0.304, Po0.005) and pulse pressure (r ¼ 0.299, Po0.005). Predialysis SBP (r ¼ 0.317, Po0.005) and pulse pressure (r ¼ 0.324, P ¼ 0.001) were also correlated with the postdialysis serum sodium change. Conclusion: Compared with HFHD, online HDF has a greater serum sodium lowering effect. This might contribute to the ability of online HDF to stabilize both pre- and postdialysis SBP.
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KEYWORD
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Blood pressure, Hemodiafiltration, Hemodialysis, Sodium
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