Role of relatively low sodium dialysate dialysis in maintenance hemodialysis patients with hypertension

Nakayama Masaru, Ishii Atsushi, Nakano Hirofumi

doi:10.4009/jsdt.41.133

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Other Title

高血圧合併維持透析患者における透析液ナトリウム濃度低下に伴う降圧効果とその機序に関する検討
コウケツアツガッペイイジトウセキカンジャニオケルトウセキエキナトリウムノウドテイカニトモナウコウアツコウカトソノキジョニカンスルケントウ

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Objectives : Hemodialysis (HD) using relatively low sodium dialysate (LSHD) has been used to control high blood pressure (BP). However, circulation volume-independent mechanisms of the anti-hypertensive effect have yet been not clearly elucidated. Methods : Twenty-five maintenance HD patients with hypertension underwent regular-HD for 12 weeks followed by LSHD for 12 weeks. Twenty-four-hour ambulatory blood pressure monitoring and echocardiography were performed at the end of each phase. Results : Significant decline in both systolic BP (178±17mmHg to 157±19mmHg, p<0.01) and diastolic BP (91±10mmHg to 84±11mmHg, p<0.01) were observed. Left ventricular chamber volumes did not demonstrate any significant difference between the 2 phases despite the equal dry-weight settings. The effective arterial elastance decreased with LSHD (2.07±0.75mmHg/mL to 1.65±0.49mmHg/mL, p<0.01). Conclusions : Reduced vascular resistance due to amelioration of sympathetic overactivity could be partly involved with the anti-hypertensive mechanisms of LSHD.

Journal

Nihon Toseki Igakkai Zasshi

Nihon Toseki Igakkai Zasshi 41 (2), 133-137, 2008

The Japanese Society for Dialysis Therapy

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