| [ Summary ] |
Hemodialysis using a Na+ concentration that is higher in the dialysate than in the serum is more effective in maintaining hemodynamic stability through body-fluid movement from the interstitium into the capillary space, which is induced by differences in osmolality between the intracellular and extracellular fluids. Furthermore, the prevalence of dialysis disequilibrium syndrome, which is likely to occur at the hemodialysis initiation period, is diminished by higher Na+ hemodialysis because of the suppression of changes in extracellular osmolality during hemodialysis, and an improvement in mortality with the use of higher Na+ hemodialysis was also reported. However, for the increase of serum osmolality accompanied by higher Na+ dialysate, stimulation of thirst, consecutive increase of intradialytic body-weight gain, and hypertension are likely to occur in the clinical setting. Therefore, this hemodialysis method might be useful for hemodialysis patients with hemodynamic instability. |