| 特集名 | 透析患者と血圧異常 | |
|---|---|---|
| 題名 | ［各論］血圧管理の実際 (2) 透析方法 2. 透析液ナトリウム濃度 | |
| 発刊年月 | 2011年 08月 | |
| 著者 | 伊丹 儀友 | 日鋼記念病院腎センター |
| 著者 | 常山 一志 | 日鋼記念病院臨床工学室・臨床工学技士 |
| 著者 | 植村 進 | 日鋼記念病院臨床工学室・臨床工学技士 |
| 【 要旨 】 | 透析間に摂取された大部分のナトリウム（Na）は，除水量（限外濾過量）で除去できると考えられ，透析中の低血圧や筋肉のつりが生じない透析Na濃度であればよいとされてきた． 短時間での高除水や効率の良い透析器の登場により，安定した透析を行うために透析液Na濃度は以前に比べ高くなってきている． 近年，個人それぞれに固有の血清Na濃度（set point）があり，それよりも高いNa濃度の透析液を使用すると，透析後にset pointに戻すべく飲水行動をとり，透析間の体重増加や高血圧の一因となっていることが知られてきた．各自のset pointに合わせた透析液Na濃度も考慮される時期にきている． |
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| Theme | Abnormal Blood Pressure in Dialysis Patients | |
|---|---|---|
| Title | Dialysate sodium concentrations | |
| Author | Noritomo Itami | Kidney Center, Nikko Memorial Hospital |
| Author | Kazushi Tsuneyama | Department of Clinical Engineering, Nikko Memorial Hospital |
| Author | Susumu Uemura | Department of Clinical Engineering, Nikko Memorial Hospital |
| [ Summary ] | In the past, it was considered that most interdialytic sodium intake could be removed through ultrafiltration as long as sodium concentrations during dialysis did not cause hypotension or muscle cramping. Because of high water removal rates over short periods of time and the availability of effective dialyzers, sodium concentrations in dialysates have been increased. In recent years it has been shown that individuals have their own particular serum sodium concentration set points. It is known that if dialysates with high sodium concentrations are used, returning to the set point, post dialysis, results in thirst, interdialytic weight gain and hypertension. In consideration of these factors, matching the sodium dialysate concentrations to the individual's set point should be taken into account. |
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