The Effect of Low Dialysate Sodium Concentration on Ambulatory Aortic Blood Pressure and Arterial Stiffness in Patients With Intradialytic Hypertension: A Randomized Crossover Study

Abstract

Intradialytic hypertension (IDH) is associated with increased cardiovascular risk. Arterial stiffness is a strong predictor of adverse outcomes in dialysis patients and may contribute to the development of the phenomenon, as patients with IDH exhibit higher ambulatory aortic blood pressure (BP) and arterial stiffness parameters than patients without IDH.  Methods: This analysis examined the effect of low (137mEq/L) compared to standard (140mEq/L) dialysate sodium concentration on 48-hour aortic BP and arterial stiffness parameters in IDH patients. In this prespecified secondary analysis of a randomized, single-blind, crossover study, 29 IDH patients underwent four hemodialysis sessions with low followed by four sessions with standard dialysate sodium or vice-versa. Mean 48-hour, pre-/post-dialysis and intradialytic aortic systolic/diastolic BP (SBP/DBP), and arterial stiffness indices were assessed.