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Lew SQ, Asci G, Rootjes PA, Ok E, Penne EL, Sam R, Tzamaloukas AH, Ing TS, Raimann JG. The role of intra- and interdialytic sodium balance and restriction in dialysis therapies. Front Med (Lausanne) 2023; 10:1268319. [PMID: 38111694 PMCID: PMC10726136 DOI: 10.3389/fmed.2023.1268319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
The relationship between sodium, blood pressure and extracellular volume could not be more pronounced or complex than in a dialysis patient. We review the patients' sources of sodium exposure in the form of dietary salt intake, medication administration, and the dialysis treatment itself. In addition, the roles dialysis modalities, hemodialysis types, and dialysis fluid sodium concentration have on blood pressure, intradialytic symptoms, and interdialytic weight gain affect patient outcomes are discussed. We review whether sodium restriction (reduced salt intake), alteration in dialysis fluid sodium concentration and the different dialysis types have any impact on blood pressure, intradialytic symptoms, and interdialytic weight gain.
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Affiliation(s)
- Susie Q. Lew
- Department of Medicine, George Washington University, Washington, DC, United States
| | - Gulay Asci
- Department of Nephrology, Ege University Medical School, Izmir, Türkiye
| | - Paul A. Rootjes
- Department of Internal Medicine, Gelre Hospitals, Apeldoorn, Netherlands
| | - Ercan Ok
- Department of Nephrology, Ege University Medical School, Izmir, Türkiye
| | - Erik L. Penne
- Department of Nephrology, Northwest Clinics, Alkmaar, Netherlands
| | - Ramin Sam
- Division of Nephrology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | - Antonios H. Tzamaloukas
- Research Service, Raymond G. Murphy Veterans Affairs Medical Center, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Todd S. Ing
- Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States
| | - Jochen G. Raimann
- Research Division, Renal Research Institute, New York City, NY, United States
- Katz School of Science and Health at Yeshiva University, New York City, NY, United States
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