Impact of Dialysate and Plasma Sodium on Mortality in a Global Historical Hemodialysis Cohort.

Date publication

novembre 2023

Journal

Journal of the American Society of Nephrology : JASN

Auteurs

Membres identifiés du Cancéropôle Est :
Pr ROSSIGNOL Patrick

Tous les auteurs :
Pinter J, Smyth B, Stuard S, Jardine M, Wanner C, Rossignol P, Wheeler DC, Marshall MR, Canaud B, Genser B

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/37967469

Résumé

Excess mortality in hemodialysis patients is largely due to cardiovascular disease and is associated with abnormal fluid status and plasma sodium concentrations. Ultrafiltration facilitates the removal of fluid and sodium, whereas diffusive exchange of sodium plays a pivotal role in sodium removal and tonicity adjustment. Lower dialysate sodium may increase sodium removal at the expense of hypotonicity, reduced blood volume refilling, and intradialytic hypotension risk. Higher dialysate sodium preserves blood volume and hemodynamic stability but reduces sodium removal. In this retrospective cohort, we aimed to assess whether prescribing a dialysate sodium ≤138 mmol/L has an impact on survival outcomes compared with dialysate sodium >138 mmol/L after adjusting for plasma sodium concentration.

Référence

J Am Soc Nephrol. 2023 11 15;: