Dialysis sodium gradient: a modifiable risk factor for fluid overload in hemodialysis patients

Objective The aim was to study the value of dialysis sodium gradient as a modifiable risk factor for fluid overload in hemodialysis patients. Background It is important to minimize sodium gradient in hemodialysis patients, as it positively correlates with changes in blood pressure during hemodialysis and intradialytic weight gain (IDWG). Patients and methods A cross-sectional analytical study was done on a group of 102 hemodialysis patients divided into three groups: group I included 56 patients with no blood pressure variability, group II included 24 patients who had intradialytic hypotension, and group III included 22 patients who had intradialytic hypertension. All patients attended the Hemodialysis Unit, Zefta General Hospital, Al-Gharbia Governorate, Egypt, during the period from May 2018 to November 2018. Complete history, hemoglobin level, predialysis and postdialysis urea and creatinine, and predialysis sodium were tested. Results There were no statistically significant differences between the studied groups regarding sex (P = 0.1939), age (P = 0.192), primary renal diseases (P = 0.189), vascular access type (P = 0.978), dialysis duration (0.976), hemoglobin (P = 0.131), predialytic and postdialytic urea (P = 0.839, P = 0.120), predialytic and postdialytic creatinine (P = 0.584, P = 0.190), ultrafiltration (UF) rate (P = 0.729), UF volume (P = 0.698), IDWG% (P = 0.777), and sodium gradient (P = 0.468). There was a positive correlation between sodium gradient and the mean IDWG%, mean UF volume, and mean UF rate among the studied hemodialysis patients. Conclusion There was a positive correlation between sodium gradient and IDWG and consequently UF volume and UF rate.