The effect of low-sodium dialysate on ambulatory blood pressure measurement parameters in patients undergoing hemodialysis

Serkan Akdag,1 Aytac Akyol,1 Huseyin Altug Cakmak,2 Aydin Rodi Tosu,3 Muntecep Asker,1 Mehmet Yaman,4 Naci Babat,1 Yasemin Soyoral,5 Muhammed Bilal Cegin,6 Ali Kemal Gur,7 Hasan Ali Gumrukcuoglu11Department of Cardiology, Yuzuncu Yil University Medical Faculty, Van, 2Department of Cardiology, Rize Kackar Government Hospital, Rize, 3Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, 4Department of Cardiology, Samsun Education and Training Hospital, Samsun, 5Department of Nephrology, 6Department of Anesthesiology and Reanimation, 7Department of Cardiovascular Surgery, Yuzuncu Yil University Medical Faculty, Van, TurkeyBackground: End stage renal disease is related to increased cardiovascular mortality and morbidity. Hypertension is an important risk factor for cardiovascular disorder among hemodialysis (HD) patients. The aim of this study was to investigate the effect of low-sodium dialysate on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels detected by ambulatory BP monitoring (ABPM) and interdialytic weight gain (IDWG) in patients undergoing sustained HD treatment.Patients and methods: The study included 46 patients who had creatinine clearance levels less than 10 mL/min/1.73 m2 and had been on chronic HD treatment for at least 1 year. After the enrollment stage, the patients were allocated low-sodium dialysate or standard sodium dialysate for 6 months via computer-generated randomization.Results: Twenty-four hour SBP, daytime SBP, nighttime SBP, and nighttime DBP were significantly decreased in the low-sodium dialysate group (P<0.05). No significant reduction was observed in both groups in terms of 24-hour DBP and daytime DBP (P=NS). No difference was found in the standard sodium dialysate group in terms of ABPM. Furthermore, IDWG was found to be significantly decreased in the low-sodium dialysate group after 6 months (P<0.001).Conclusion: The study revealed that low-sodium dialysate leads to a decrease in ABPM parameters including 24-hour SBP, daytime SBP, nighttime SBP, and nighttime DBP and it also reduces the number of antihypertensive drugs used and IDWG.Keywords: hypertension, sodium dialysate, hemodialysi