The influence of low dialysate sodium and glucose concentration on volume distributions in body compartments after haemodialysis: a bioimpedance analysis study

Background. Despite the developments in haemodialysis, there are still some difficulties in maintaining the haemodynamic stability. Bioimpedance analysis (BIA) has been proposed for the estimation of dry weight in haemodialysis patients. We aimed to investigate the effects of dialysate sodium and gl...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2008-11, Vol.23 (11), p.3629-3634
Main Authors: Ozturk, Savas, Taymez, Dilek Guven, Bahat, Gulistan, Demirel, Reyhan, Yazıcı, Halil, Aysuna, Nilgun, Sakar, Sule, Yildiz, Alaattin
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
bioimpedance analysis
Biological and medical sciences
Body Composition - drug effects
Body Composition - physiology
Body Weight - drug effects
Body Weight - physiology
Chronic Disease
Cross-Over Studies
dialysate glucose
dialysate sodium
Electric Impedance
Emergency and intensive care: renal failure. Dialysis management
Female
Glucose - analysis
Glucose - pharmacology
haemodialysis
Hemodialysis Solutions - chemistry
Hemodialysis Solutions - pharmacology
Hemodynamics - drug effects
Hemodynamics - physiology
Humans
Intensive care medicine
intradialytic hypotension
Kidney Diseases - physiopathology
Kidney Diseases - therapy
Male
Medical sciences
Middle Aged
Prospective Studies
Renal Dialysis
Sodium - analysis
Sodium - pharmacology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Young Adult
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Summary:Background. Despite the developments in haemodialysis, there are still some difficulties in maintaining the haemodynamic stability. Bioimpedance analysis (BIA) has been proposed for the estimation of dry weight in haemodialysis patients. We aimed to investigate the effects of dialysate sodium and glucose contents on volume distribution in body compartments after haemodialysis by using BIA, a sensitive and reliable method. Methods. Seventeen chronic haemodialysis patients [11 males, 6 females, mean age: 36.9 (18–64) years] were included in the study. Patients were evaluated in three periods. The patients (period 1-P1) underwent haemodialysis with dialysate of 200 mg/dL glucose and 140 mmol/dL sodium for 4.5 h in the middle session of the first week. At the beginning and the end of the session, haematocrit, vital parameters (blood pressure, pulse), ultrafiltrated volume, plasma osmolarity and plasma renin activity were recorded. Also multi-frequency bioelectric impedance analyses (Bodystat®Quadscan 4000) were applied to all patients at 5, 50, 100 and 200 kHz, including the impedance index (Z200/Z5). In the second midweek session the same procedure was repeated with same glucose concentration and 135 mmol/dL sodium including dialysate (period 2-P2), and in the third week, it was performed with a dialysate that included 140 mmol/dL sodium and no glucose (period 3-P3). Results. The change of the ratio of the intracellular volume to total body weight (ICV/TBW) at the beginning and the end of the session was same in all periods. However, there were significant differences in the change (after/before session) ratio for the extracellular volume/total body weight (ECV/TBW) in P2 compared to other periods (P values for P1–P2:
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfn274