Effect of Dialysate Sodium Profiling on Blood Pressure in Haemodialysis Patients in Haemodialysis Center in 2019-2020

Authors

  • Ibrahim Suliman Tishreen University
  • Mohammad Al Jamal Tishreen University

Abstract

Introduction: Intra-Dialytic hypotension (IDH) is one of the most common complications during hemodialysis sessions in chronic hemodialysis patients. Sodium profiling is one of many available therapeutic choices to prevent IDH. We aimed in this study to know effects of sodium profiling on blood pressure and Inter-dialytic weight gain (IDWG) in chronic hemodialysis patients.

Methods: We studied 93 patients (55 male, 38 female), aged 51.17 ± 15.05 (SD) years that undergo hemodialysis sessions regularly in Tishreen University Hospital during the period from 05/2019 to 11/2019. We have three modes of sodium profiling (mode 1:135 mEq\l – mode 2:145 – 135 mEq\l Linear – mode 3:148 – 138 mEq\l Linear) each patient had 8 sessions in every mode (744 sessions for all patients in each mode, 2322 sessions in entire study period) with monitoring of: systolic and diastolic blood pressure pre- and post-dialysis, IDWG in every session, incidence of IDH if it happened and periodic blood tests.

Results: There were statistical differences in Δ SBP (pre- and post-dialysis systolic blood pressure) (mode 1 = 16.00 ± 3.6 mmHg, mode 2 = 22.29 ± 3.5 mmHg, mode 3 = 11.48 ± 4.8 mmHg) (P.value < 0.001), also there were statistical differences in IDWG (in mode 1 = 2.69 ± 1.03 kg, in mode 2 = 2.67 ± 1.01 kg, in mode 3 = 3.03 ± 1.03) (P.value < 0.01), and there were statistical differences in incidence of IDH (65 sessions in mode 1 (8.73%), 112 sessions in mode 2 (15.05%), 39 sessions in mode 3 (5.24%) (P.value < 0.01), there was also weak correlation R = 0.34 between (DM) Diabetes Mellitus and incidence of IDH in Mode 1 (P.value < 0.001), and moderate correlation R = 0.52 in Mode 2 (P.value < 0.001), and moderate correlation R = 0.63 in Mode 3 (P.value < 0.001), and we found weak correlation R = 0.24 between hypertension and the incidence of IDH in Mode 3 (P.value < 0.001), we also found a relationship between dialysis vintage and IDWG and IDWG% which increase the incidence of IDH in Mode 1 (OR = 1.39, P.value = 0.013) and in Mode 2 (OR = 1.48, P.value = 0.007) and in Mode 3 (OR = 1.48, P.value = 0.049).

Conclusions: We can use sodium profiling maneuvers to reduce the incidence of IDH and control of IDWG; but with caution in: DM, high dialysis vintage patients, hypertension.

Author Biographies

Ibrahim Suliman, Tishreen University

Professor - Department of Internal Medicine, Faculty of Medicine

Mohammad Al Jamal, Tishreen University

Postgraduate Student (MSc) - Department of Internal Medicine, Faculty of Medicine

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Published

2021-05-31

How to Cite

1.
سليمان ا, الجمل م. Effect of Dialysate Sodium Profiling on Blood Pressure in Haemodialysis Patients in Haemodialysis Center in 2019-2020. Tuj-hlth [Internet]. 2021May31 [cited 2024Apr.28];43(2). Available from: https://journal.tishreen.edu.sy/index.php/hlthscnc/article/view/10597

Issue

Vol. 43 No. 2 (2021): Tishreen University Journal for Research and Scientific Studies - Health Sciences Series

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