Why do you need to determine the sodium concentration after dialysis?
Interdialytic water and sodium loads must be corrected on an individual basis because they vary from patient to patient and from one session to the next. Therefore, a post-dialysis plasma sodium concentration target must be determined for each individual patient. To determine the optimal target, the clinical circumstances (absence of hypertension and fluid overload), the individual pre-dialysis sodium level and overall sodium balance of the patient must be taken into consideration. This is easiest for a stable, normonatremic patient as the sodium concentration post dialysis should generally be the same as that pre-dialysis.
Why do hyponatremic patients regain their lower sodium levels during the interdialysis interval?
Hyponatremic patients often regain their lower plasma sodium concentrations during the interdialytic interval due to thirst and a subsequent increased water intake. This occurs from hypernatremic dialysis sessions that are conducted with the intention of normalizing post dialysis plasma concentrations.
What is the effect of sodium balance neutral?
They observed that with similar intradialytic sodium removal with the use of a sodium balance-neutral linearly decreasing sodium profile combined with linearly decreasing UF profile, greater intradialytic stability of the blood volume, blood pressure and cardiac function could be obtained and hypotensive episodes were significantly reduced.
Why are dialysate sodium profiles used?
These profiles are the most widely used because you can take advantage of the positive effects of high dialysate sodium concentrations on plasma osmolality and plasma refilling at the beginning of the treatment , when ultrafiltration is best tolerated.
What should the sodium concentration be in isonatremic dialysis?
In isonatremic dialysis, the sodium concentration in the dialysate should be higher (approximately 2-3%) than in the plasma to avoid net diffusive loss and gain of sodium 1.
What is the purpose of sodium in SVS?
The intent is to slow the rate at which sodium leaves the bloodstream into the dialysate.
Is dialysate sodium a negative effect?
There can be negative consequences to a high dialysate sodium concentration. Sodium can accumulate in the patient leading to an increased post-dialysis thirst, increased interdialytic weight gain and the development of hypertension. SVS was developed to achieve the benefits of high plasma sodium levels while at the same time avoiding unnecessary high intradialytic sodium uptake by the patient with the associated risk of sodium loading. SVS allows modification of the plasma osmolality during the dialysis session to minimize intradialytic side-effects while removing the amount of sodium necessary to avoid sodium overload.