Evidence mapPaperPMID 38710537Full record

Trial reportNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2024

Low dialysate sodium and 48-h ambulatory blood pressure in patients with intradialytic hypertension: a randomized crossover study.

Fotini Iatridi, Konstantinos Malandris, Robert Ekart, Efstathios Xagas, Antonios Karpetas, Marieta P Theodorakopoulou, Artemios Karagiannidis, Areti Georgiou, Aikaterini Papagianni, Pantelis Sarafidis

2 registry-linked trialsAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05430438 nacompletednot on this map

Effect of Low Versus Standard Dialysate Sodium on 48h Ambulatory BP in Patients With Intradialytic Hypertension

TypeinterventionalSponsorAristotle University Of ThessalonikiRan2022 to 2023Enrolled30ConditionsIntradialytic Hypertension, End Stage Kidney DiseaseArmsdialysis with low dialysate sodium concentration, dialysis with standard dialysate sodium concentration
NCT07459348 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Can Changes in Dialysate Sodium Concentration Improve Blood Pressure and Endothelial Function in Patients Undergoing Chronic Hemodialysis?

TypeinterventionalSponsorGødstrup HospitalRan2026 to 2029Enrolled25ConditionsDialysis Dependent Chronic Kidney Disease, Dialysis Patients, Sodium Excess, High Blood PressureArmsLow-Sodium Dialysate (133 mmol/L), Standard-Sodium Dialysate (139 mmol/L)
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Low dialysate sodium levels for chronic haemodialysis.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Fotini IatridiFirst Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID 0000-0001-8863-227X
Konstantinos MalandrisClinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Robert EkartDepartment of Nephrology, University Clinical Centre Maribor, Maribor, Slovenia.
Efstathios XagasFrontis Dialysis Center, Athens, Greece.
Antonios KarpetasTherapeutiki Hemodialysis Unit, Thessaloniki, Greece.
Marieta P TheodorakopoulouFirst Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID 0000-0001-6216-9635
Artemios KaragiannidisFirst Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID 0000-0002-7054-1422
Areti GeorgiouFirst Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Aikaterini PapagianniFirst Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Pantelis SarafidisFirst Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID 0000-0002-9174-4018

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntradialytic hypertension (IDH) is associated with increased risk for cardiovascular events and mortality. Patients with IDH exhibit higher 48-h blood pressure (BP) levels than patients without this condition. Volume and sodium excess are considered a major factor contributing in the development of this phenomenon. This study evaluated the effect of low (137 mEq/L) compared with standard (140 mEq/L) dialysate sodium concentration on 48-h BP in patients with IDH.

methodsIn this randomized, single-blind, crossover study, 29 patients with IDH underwent four hemodialysis sessions with low (137 mEq/L) followed by four sessions with standard (140 mEq/L) dialysate sodium, or vice versa. Mean 48-h BP, pre-/post-dialysis and intradialytic BP, pre-dialysis weight, interdialytic weight gain (IDWG) and lung ultrasound B-lines were assessed.

resultsMean 48-h systolic/diastolic BP (SBP/DBP) were significantly lower with low compared with standard dialysate sodium concentration (137.6 ± 17.0/81.4 ± 13.7 mmHg with low vs 142.9 ± 14.5/84.0 ± 13.9 mmHg with standard dialysate sodium, P = .005/P = .007, respectively); SBP/DBP levels were also significantly lower during the 44-h and different 24-h periods. Low dialysate sodium significantly reduced post-dialysis (SBP/DBP: 150.3 ± 22.3/91.2 ± 15.1 mmHg with low vs 166.6 ± 17.3/94.5 ± 14.9 mmHg with standard dialysate sodium, P < .001/P = .134, respectively) and intradialytic (141.4 ± 18.0/85.0 ± 13.4 mmHg with low vs 147.5 ± 13.6/88.1 ± 12.5 mmHg with standard dialysate sodium, P = .034/P = .013, respectively) BP compared with standard dialysate sodium. Pre-dialysis weight, IDWG and pre-dialysis B lines were also significantly decreased with low dialysate sodium.

conclusionsLow dialysate sodium concentration significantly reduced 48-h ambulatory BP compared with standard dialysate sodium in patients with IDH. These findings support low dialysate sodium as a major non-pharmacologic approach for BP management in patients with IDH.

trial registrationClinicalTrials.gov study number NCT05430438.

Indexed as

Cross-Over StudiesHypertensionRenal DialysisSodiumAgedBlood PressureBlood Pressure Monitoring, AmbulatoryDialysis SolutionsFemaleFollow-Up StudiesHumansKidney Failure, ChronicMaleMiddle AgedPrognosisSingle-Blind MethodDialysis SolutionsSodiumABPMblood pressuredialysate sodiumhemodialysisintradialytic hypertension (IDH)

Identifiers

PMID38710537
PMCPMC11522792

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.