Are Dialysate Sodium Levels Too High?

作者：Marshall Mark R^*; Dunlop Joanna L

来源：Seminars in Dialysis, 2012, 25(3): 277-283.

DOI：10.1111/j.1525-139X.2012.01072.x

Universal lower dialysate [Na+] is often advocated as a means of improving the dire cardiovascular plight of our dialysis patients. However, there is evidence associating lower dialysate [Na+] and increased morbidity and mortality especially in frailer patients, probably as a result of more frequent intra-dialytic hypotension. In this editorial, we summarize arguments for and against lower dialysate [Na+], and provide recommendations around selecting the most appropriate dialysate [Na+] for specific clinical subsets that may benefit from manipulation of salt and water balance. The lack of overall clarity on relative benefits and risks of lower dialysate [Na+] does not support the case for empirical across the board change, and experimental testing in clinical trials is required to determine safe and effective use.

• 出版日期2012-6