| Title: |
Mild sodium reduction in peritoneal dialysis solution improves hypertension in end stage kidney disease: a case-report study |
| Authors: |
Luigi Vecchi; Mario Bonomini; Roberto Palumbo; Arduino Arduini; Silvio Borrelli |
| Contributors: |
Vecchi, Luigi; Bonomini, Mario; Palumbo, Roberto; Arduini, Arduino; Borrelli, Silvio |
| Publication Year: |
2021 |
| Collection: |
ARUd'A - Archivio Istituzionale della ricerca dell'università Chieti-Pescara (IRIS) |
| Subject Terms: |
Low-sodium; Resistant hypertension; Peritoneal Dialysis |
| Description: |
Introduction: Blood Pressure (BP) control is largely unsatisfied in End Stage Kidney Disease (ESKD) principally due to sodium retention. Peritoneal Dialysis (PD) is the most common type of home dialysis, using a peritoneal membrane to remove sodium, though sodium removal remains challenging. Methods: This is a case-study reporting two consecutive ESKD patients treated by a novel peritoneal PD solution with a mildly reduced sodium content (130 mmol/L) to treat hypertension. Results: In the first case, a 78-year-old woman treated by Continuous Ambulatory PD (CAPD) with standard solution (three 4 h-dwells per day 1.36% glucose 132 mmol/L) showed resistant hypertension confirmed by ambulatory blood pressure monitoring (ABPM), reporting 24 h-BP: 152/81 mmHg, day-BP:151/83 mmHg and night-ABP: 153/75 mmHg, with inversion of the circadian systolic BP rhythm (1.01), despite use of three anti-hypertensives and a diuretic at adequate doses. No sign of hypervolemia was evident. We then switched from standard PD to low-sodium solution in all daily dwells. A six-months low-sodium CAPD enabled us to reduce diurnal (134/75 mmHg) and nocturnal BP (122/67 mmHg), restoring the circadian BP rhythm, with no change in ultrafiltration or residual diuresis. Diet and drug prescription were unmodified too. The second case was a 61-year-old woman in standard CAPD (three 5 h-dwells per day) suffering from hypertension confirmed by ABPM (mean 24 h-ABP: 139/84 mmHg; mean day-ABP:144/88 mmHg and mean night-ABP:124/70 mmHg). She was switched from 132-Na CAPD to 130-Na CAPD, not changing dialysis schedule. No fluid expansion was evident. During low-sodium CAPD, antihypertensive therapy (amlodipine 10 mg and Olmesartan 20 mg) has been reduced until complete suspension. After 6 months, we repeated ABPM showing a substantial reduction in mean 24 h-ABP (117/69 mmHg), mean diurnal ABP (119/75 mmHg) and mean nocturnal ABP (111/70 mmHg). Ultrafiltration and residual diuresis remained unmodified. No side effects were reported in either cases. ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/33964894; info:eu-repo/semantics/altIdentifier/wos/WOS:000648387800001; volume:22; issue:1 / Article Number: 170; firstpage:1; lastpage:6; numberofpages:6; journal:BMC NEPHROLOGY; https://hdl.handle.net/11564/751804 |
| DOI: |
10.1186/s12882-021-02380-4 |
| Availability: |
https://hdl.handle.net/11564/751804; https://doi.org/10.1186/s12882-021-02380-4; https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02380-4 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.3F632953 |
| Database: |
BASE |