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Nephrol Ther. 2014 Apr;10(2):94-100. doi: 10.1016/j.nephro.2013.11.004. Epub 2014 Feb 4.

[Extracellular hydration status and residual urinary sodium excretion in chronic hemodialysis patients: a cross-sectional multicenter study].

[Article in French]

Author information

1
Service de néphrologie, centre hospitalier universitaire de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
2
Service de néphrologie, centre hospitalier universitaire de Caen, hôpital Clémenceau, boulevard Georges-Clémenceau, CS 30001, 14033 Caen cedex 9, France.
3
Service de néphrologie hémodialyse, hôpital Bois-Guillaume, 147, avenue du Maréchal-Juin, 76230 Bois-Guillaume, France.
4
Service de néphrologie hémodialyse, centre hospitalier du Cotentin, BP 208, 50102 Cherbourg-Octeville cedex, France.
5
Service d'hémodialyse, centre hospitalier Mémorial, 715, rue Dunant, 50000 Saint-Lô, France.
6
Service d'hémodialyse, centre hospitalier, 25, rue Fresnay, 61000 Alençon, France.
7
Service de néphrologie hémodialyse, centre hospitalier Robert-Bisson, 4, rue Aini, 14100 Lisieux, France.
8
Service de néphrologie, centre hospitalier universitaire de Caen, hôpital Clémenceau, boulevard Georges-Clémenceau, CS 30001, 14033 Caen cedex 9, France. Electronic address: henri-p@chu-caen.fr.

Abstract

BACKGROUND:

In dialysis patients, a misevaluation of dry weight may lead to an increased morbidity and mortality. The aim of this cross-sectional multicenter study was to evaluate the association between residual urinary sodium excretion and extracellular volume status in chronically treated hemodialysis patients.

PATIENTS AND METHODS:

Dry weight was determined clinically and by whole-body bioimpedance spectroscopy (Body Composition Monitor, Fresenius Medical Care) prior to a mid-week session in 40 chronic hemodialysis patients with significant residual diuresis (more than 250 mL per day) and receiving treatment in four dialysis centers. Regarding their hydration status assessed by the Body Composition Monitor and in comparison to a healthy reference population, patients were assigned to 1 of the 3 categories: overhydrated, normohydrated and dehydrated. Urine output, urinary sodium excretion and residual renal function were measured for all patients within 30 days before dry weight assessment.

RESULTS:

The median post-HD session FO was of-0.40 L (IQR: from-1.95 to+0.90) and the median residual urinary sodium excretion was of 64 mmol/L (IQR: 46-79). Among these patients, 16 were normohydated, 16 were dehydrated and 8 were overhydrated. There was a linear relationship between the hydration status after HD session and the urinary sodium excretion (estimate: 5.6±1.5; p<0.001). Compared with normohydrated patients, overhydrated patients had a higher residual urinary sodium excretion (estimate: 26±10; p<0.01).

CONCLUSION:

In this study, urinary sodium excretion is associated with the hydration status evaluated by whole-body bioimpedance spectroscopy.

KEYWORDS:

Dry weight; Hemodialysis; Hémodialyse chronique; Natriurèse; Poids sec; Urinary sodium excretion

PMID:
24508000
DOI:
10.1016/j.nephro.2013.11.004
[Indexed for MEDLINE]

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