Sodium and ultrafiltration profiling in hemodialysis: A long-forgotten issue revisited |
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Authors: | Lale A Ertuglu Atalay Demiray Carlo Basile Baris Afsar Adrian Covic Mehmet Kanbay |
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Affiliation: | 1. Department of Medicine, Koc University School of Medicine, Istanbul, Turkey;2. Division of Nephrology, Miulli General Hospital, Acquaviva delle Fonti, Italy;3. Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey;4. Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania;5. Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey |
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Abstract: | Sodium and ultrafiltration profiling are method of dialysis in which dialysate sodium concentration and ultrafiltration rate are altered during the course of the dialysis session. Sodium and ultrafiltration profiling have been used, commonly simultaneously, to improve hemodynamic stability during hemodialysis. Sodium profiling is particularly effective in decreasing the incidence of intradialytic hypotension, while ultrafiltration profiling is suggested to decrease subclinical repeated end organ ischemia during dialysis. However, complications such as increased interdialytic weight gain and thirst due to sodium excess have prevented widespread use of sodium profiling. Evidence suggest that different sodium profiling techniques may lead to different clinical results, and preferring sodium balance neutral sodium profiling may mitigate adverse effects related to sodium overload. However, evidence is lacking on the long-term clinical outcomes of different sodium profiling methods. Optimal method of sodium profiling as well as the utility of sodium/ultrafiltration profiling in routine practice await further clinical investigation. |
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Keywords: | hemodialysis interdialytic weight gain sodium profiling ultrafiltration |
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