Abstract
High sodium dialysate plays a very important role in prevention of hypotension during dialysis and general fatigue after dialvsis, increase in appetite, improvement of anemia, and loss of basal body weight. As plasma osmotic pressure is maintained at higher level in high sodium dialysate, plasma refilling rate from interstitial tissues into capillary is larger than in conventional low sodium dialysate.
Several types of therapy used high sodium difalysate are as follows: dialysis with physiological sodium concentration (less than 150mEq/l) in dialysate, with unphysidogical sodium dialysate concentration (more than 160mEq/l), sodium gradient method (SGM), and cell-wash dialysis (CWD).
In unphysiological high sodium dialysate (UPHSD), clinical findings such as improvement of nitrogen metabolism and large amount of intracellular fluid removal are recognized. At the same time, however, it is difficult to maintain sodium balance. To solve this problem, sodium gradient method (SGM) and cell-wash dialysis (CWD) would be effective.
In a case having been treated with CWD for more than 2 years, clinical results are observed as follows: disappearance of angina attack, decrease of urea appearance and increase in removal amount of potassium.
Therefore, high sodium dialysate would be actively used to cases who have side effects treated with conventional dialysis.
