Investigation of the Effects of Stepwise Sodium and Ultrafiltration Profile on Dialysis Adequacy

Background: One of the leading causes of disability and mortality among patients receiving hemodialysis (HD) is HD inadequacy. Enhancing HD adequacy can improve the prognosis for these patients. Objectives: This study sought to investigate the effects of stepwise sodium and ultrafiltration profile on HD adequacy. Patients and Methods: This crossover clinical trial was conducted on 30 patients, who were receiving HD in two HD centers, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Each participant received HD in four routine HD sessions and four stepwise sodium and ultrafiltration profile sessions. Hemodialysis adequacy was calculated online by a software installed on the HD machines. The data were analyzed by conducting the paired-samples t test. Results: The mean of dialyzer urea clearance multiplied by time, divided by volume of distribution of urea (Kt/V) ratio in the routine HD and the stepwise sodium and ultrafiltration profile groups were 1.237 and 1.395, respectively. This difference was statistically significant (P < 0.05). Conclusions: Sodium and ultrafiltration profile maintain hemodynamic stability through adjusting sodium concentration and ultrafiltration and, therefore, they improve HD adequacy, as well as patients’ tolerance to HD. Consequently, replacing routine HD techniques with this technique is recommended.