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21. Effect of Low Sodium Dialysate on Regression of Left Ventricular Hypertrophy in Hemodialysis Patients

Adnan Akhtar1, Shakeel Khan1, Usman Khalid2, Khawar Sultan1 and Muhammad 

Kashif Khan1

ABSTRACT

Objective: To compare the effect of low sodium dialysate with the standard sodium dialysate in terms of regression of left ventricular hypertrophy in dialysis patients.

Study Design: Randomized controlled trial study

Place and Duration of Study: This study was conducted at the Nephrology Department, PIMS Islamabad. Duration of study from March, 2018 to August, 2018.

Materials and Methods: This study involved eighty-four Dialysis dependent patients (n=84) of either gender aged between 18-65 years with hypertension and LVEF>40%.  They were randomly divided into two groups. Intervention group was switched to 136 mmol/L dialysate sodium (low sodium) while control group were kept on dialysate sodium concentration of 140 mmol/L (standard sodoum).  Study outcomes were measured in terms of interdialyctic weight gain, blood pressure response and left ventricular mass index (LVMI) at six months.

Results: There were 71.4% (n=30/42) males and 28.6% (n=12/42) females in low sodium group and were 57.1% (n=24/42) males and 42.9% (n=18/42) females in standard sodium group. In low sodium group, mean age was 41.2 years ± 8.8 SD, mean height was 1.64 m ± 0.06 SD and mean weight was 73.4 Kg ± 10.4 SD. In standard sodium group, mean age was 44.7 years ± 9.5 SD, mean height was 1.68 m ± 0.06 SD and mean weight was 74.2 Kg ± 9.9 SD.  In low sodium group, mean LVEF was 48.5 % ± 2.3 SD, mean interdialyctic weight gain was 2.58 Kg ± 0.43 SD, mean systolic BP was 155.2 mmHg ± 7.5 SD, mean diastolic BP was 99.5 mmHg ± 6.6 SD and mean LVMI was 123.6 g/m2 ± 13.5 SD. In standard sodium group, mean LVEF was 49.1 % ± 2.6 SD, mean interdialyctic weight gain was 2.53 Kg ± 0.44 SD, mean systolic BP was 156.1 mmHg ± 7.9 SD, mean diastolic BP was 101.2 mmHg ± 6.6 SD and mean LVMI was 123.3 g/m2 ± 14.6 SD.  At six months, mean interdialyctic weight gain was 2.02 Kg ± 0.43 SD in the low sodium group compared with 2.53 ± 0.43 SD in standard sodium group, (Ρ=0.001).  Mean systolic blood pressure was 147.5 mmHg ± 7.9 SD in the low sodium group compared with 157.5 mmHg ± 8.2 SD in standard sodium group, (Ρ=0.001). Low sodium tends to lower down the systolic pressure when compared to high sodium. Mean diastolic blood pressure was 99.5 mmHg ± 5.9 SD in the low sodium group compared with 101.2 mmHg ± 6.6 SD in standard sodium group, no significant difference was observed in diastolic blood pressure in both the groups at six months (P=0.06).  Mean LVMI was 121.8 g/m2 ± 13.5 SD in low sodium group while it was 131.8 g/m2 ± 14.6 SD in standard sodium group (p=0.003).

Conclusion: Mean interdialyctic weight gain was significantly lesser and mean LVMI was significantly lower in low sodium group compared to standard sodium group. Low sodium tends to lower down the systolic pressure when compared with standard sodium group at six months.   Key Words: Dialysis, Dialysate, Sodium.

Citation of article: Akhtar A, Khan S, Khalid U, Sultan K, Khan MK. Effect of Low Sodium Dialysate on Regression of Left Ventricular Hypertrophy in Hemodialysis Patients Med Forum 2021;32(2):88-92.