Hypertension Clinical Trial
Unfavorably high sodium intakes remain prevalent around the world. A negative sodium
gradient in hemodialysis treatment results in absolute sodium removal via diffusive
transport of sodium from the blood to the dialysate, and it may be a potentially useful tool
to improve sodium loading due to excess dietary sodium intake.
The purpose of this study is to determine whether a in small negative sodium gradient could
improve blood pressure level, arterial stiffness and left ventricular hypertrophy in
hypertensive hemodialysis patients, who had been achieving and maintaining their dry weight
assessed by bioimpedance spectroscopy.
A number of studies have shown that lowering dialysate sodium concentration could improve
blood pressure (BP) control, and the lower BPs are considered to be a result of an
improvement in volume status via increasing sodium removal. However, sodium, apart from
volume, may have an independent effect on BP regulation. It is speculated that a reduction
in exchangeable sodium, even without a change in body water content, may improve BP control.
Unfortunately, as of yet, no clinical studies have actually provided the evidence in this
field.
In general population, dietary salt loading produces significant increase in aortic pulse
wave velocity, which is reversed by lowering sodium intake. To the investigators knowledge,
the effect of sodium on arterial stiffness has not been investigated in hemodialysis
patients.
A regression of left ventricular hypertrophy (LVH) has been achieved through strict dietary
sodium restriction in hemodialysis patients. Lack of effect on LVH was observed in low
sodium dialysis which may be due to the shorter time interval.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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