Charra B, Chazot C, Jean G, Hurot J-M, Terrat J-C, Vanel T, Lorriaux C, Vovan C
Center of Artificial Kidney, France.
Minerva Urol Nefrol. 2004 Sep;56(3):205-13.
The total amount of sodium present in the body conditions the extracellular compartment volume. In advanced renal failure and in dialysis the sodium balance becomes positive and the extracellular volume inflates. This leads to hypertension and to direct cardiac and vascular changes that explain for a large part the excessive cardiovascular morbidity and mortality in dialysis patients. Controlling body sodium content and extracellular volume allows to reduce hypertension, cardiovascular changes and to improve dialysis patients survival. This can be achieved by reducing the sodium input (low sodium diet and reasonably low sodium dialysate) and/or by increasing sodium output (ultrafiltration by convection in hemodialysis or hemofiltration and osmotic drive in peritoneal dialysis). The intermittent nature of hemodialysis (and hemofiltration) conditions the saw-tooth volume fluctuations that drove to conceiving and implementing the concept of a dry weight, corresponding to normal extracellular volume and blood pressure.
体内钠的总量决定细胞外液量。在晚期肾衰竭和透析过程中，钠平衡变为正值，细胞外液量增加。这会导致高血压以及直接的心脏和血管变化，这在很大程度上解释了透析患者心血管发病率和死亡率过高的原因。控制体内钠含量和细胞外液量可降低高血压、改善心血管变化并提高透析患者的生存率。这可以通过减少钠的摄入（低钠饮食和适度低钠透析液）和/或增加钠的排出（血液透析或血液滤过中的对流超滤以及腹膜透析中的渗透驱动力）来实现。血液透析（和血液滤过）的间歇性导致锯齿状的容量波动，从而促使人们构思并实施了干体重的概念，即对应于正常细胞外液量和血压的体重。
