Jin Haifeng, Lee Seung Yun, Lee Si Nae, Song Joon Ho, Kim Moon-Jae, Lee Seoung Woo
Division of Nephrology, Department of Internal Medicine, Yanbian University Hospital, Yanji, Jilin Province, China.
Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
Electrolyte Blood Press. 2014 Dec;12(2):66-73. doi: 10.5049/EBP.2014.12.2.66. Epub 2014 Dec 31.
This retrospective study was performed to determine the ranges of the sodium gradient (SG) between the dialysate sodium concentration (DNa) and serum sodium concentration (SNa) in hemodialysis (HD) patients and to examine the relationships between HD parameters over a 1 year period. Fifty-five clinically stable HD patients, who had been on HD >2 years were enrolled. Monthly HD [ultrafiltration (UF) amount, systolic blood pressure (SBP), frequency of intradialytic hypotension (IDH)] and laboratory data were collected and 12-month means were subjected to analysis. The SG was calculated by subtracting SNa from prescribed DNa. Mean SG values were 1.5±3.3 (range -5.6~9.1). SG was positively related to DNa and the frequency of IDH. A higher SG was associated with larger UF amounts and SBP reduction during HD. The percentages of patients with a SG ≥3mEq/L increased as DNa increased. On the other hand, SG was not found to be associated with SNa or pre-HD SBP. DNa appears to cause a significant increase in SG, and this seems to be related to HD parameters, such as, UF amount and IDH.
本回顾性研究旨在确定血液透析（HD）患者透析液钠浓度（DNa）与血清钠浓度（SNa）之间的钠梯度（SG）范围，并研究1年内HD参数之间的关系。纳入了55例临床稳定、已接受HD治疗超过2年的患者。收集每月的HD数据[超滤量（UF）、收缩压（SBP）、透析中低血压（IDH）发生频率]及实验室数据，并对12个月的均值进行分析。SG通过用规定的DNa减去SNa来计算。平均SG值为1.5±3.3（范围为-5.6至9.1）。SG与DNa及IDH发生频率呈正相关。较高的SG与HD期间较大的UF量及SBP降低相关。随着DNa升高，SG≥3mEq/L的患者百分比增加。另一方面，未发现SG与SNa或HD前SBP相关。DNa似乎会导致SG显著升高，这似乎与HD参数如UF量和IDH有关。
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