{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T21:31:09Z","timestamp":1763415069952,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Large interdialytic weight gain (IDWG) is associated with increased morbidity and mortality in chronic hemodialysis patients. Over 50% of patients at our inner city tertiary academic center dialysis unit had IDWG and target weights (TW) above goal. We conducted an open\u2010label nonrandomized study to explore the effects of an individualized dialysate sodium (DNa) prescription using Na gradients in patients at high risk for large IDWG. Thirty\u2010three patients receiving chronic hemodialysis received individualized DNa prescriptions with a DNa bath of 0 to \u22122\u2009meq\/L below their serum Na level in the intervention group, while patients in the control group were prescribed the standard dialysate Na at 138\u2009mmol\/L. Serum Na level, predialysis SBP, symptomatic hypotensive episodes, and %hemodialysis treatments with large IDWG (%TxAIDWG) and above TW(%TxATW) were recorded before and three months after the intervention. We used student <jats:italic>t<\/jats:italic> tests to compare continuous variables and Chi\u2010square tests to compare binary variables between the groups at baseline and after the intervention. Age\u2010 and sex\u2010adjusted linear regression models were also constructed to assess the differences in each continuous outcome between the groups. Multivariable logistic regression models were conducted by modeling IDWG decrease and above estimated\u2010dry\u2010weight (EDW) decrease as binary dependent variables with adjustment for age, sex, and EDW change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Patients with individualized DNa concentrations had 3.6 times greater odds of having lower IDWG than those with standard dialysate Na concentration. This significant association remained after adjustment for age, sex, and changes in EDW (OR: 3.63; 95% CI, 1.03\u201312.9). There was no difference in predialysis BP or symptomatic hypotensive episodes between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Individualized DNa prescriptions appeared to be well tolerated and may be effective for optimal fluid management in high\u2010risk hemodialysis patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.12830","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T07:50:50Z","timestamp":1583481050000},"page":"406-413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Individualized dialysate sodium prescriptions using sodium gradients for high\u2010risk hemodialysis patients lowered interdialytic weight gain and achieved target weights"],"prefix":"10.1111","volume":"24","author":[{"given":"Kavitha","family":"Ramaswamy","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmin","family":"Brahmbhatt","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Richard M. Fairbanks School of Public Health Indiana University  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiqing","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Richard M. Fairbanks School of Public Health Indiana University  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5496-4986","authenticated-orcid":false,"given":"Jingjing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"United States Renal Data System: USRDS 2018Annual Data Report: Chapter 5: Mortality Vol 2 Figure 5.4a Unadjusted percentages of deaths in 2015 by cause with. And without missing data by modality among dialysis patients and transplant patients National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases 2018"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr678"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09460912"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016121341"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.07.003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","unstructured":"MendozaJMM BayesL SunS DossS SchillerB.Effect of lowering dialysate sodium concentration on Interdialytic weight gain and blood pressure in patients undergoing thrice\u2010weekly in\u2010center nocturnal hemodialysis: A quality improvement study American journal of kidney disease.2011;58:956\u2013963.","DOI":"10.1053\/j.ajkd.2011.06.030"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2012.00701.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.08.030"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05440611"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/039139880703001105"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12570"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.07609.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/16.8.1538"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm020"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12655"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv084"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-018-0870-0"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12645"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03900808"}],"container-title":["Hemodialysis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.12830","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hdi.12830","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.12830","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T11:02:25Z","timestamp":1693738945000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hdi.12830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,5]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/hdi.12830"],"URL":"https:\/\/doi.org\/10.1111\/hdi.12830","archive":["Portico"],"relation":{},"ISSN":["1492-7535","1542-4758"],"issn-type":[{"type":"print","value":"1492-7535"},{"type":"electronic","value":"1542-4758"}],"subject":[],"published":{"date-parts":[[2020,3,5]]},"assertion":[{"value":"2019-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}