Abstract
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.
