O

BUN H2O

Na H2O

Indications Intradialysis hypotension Cramping

Initiation of hemodialysis in setting of severe azotemia Hemodynamic instability (eg, intensive care setting) Contraindications Intradialysis development of hypertension Large interdialysis weight gain induced by high-sodium dialysate Hypernatremia

INDICATIONS AND CONTRAINDICATIONS FOR USE OF SODIUM MODELING (HIGH/LOW PROGRAMS)

Use of a low-sodium dialysate is more often associated with intra-dialysis hypotension as a result of several mechanisms [4]. The drop in serum osmolality as urea is removed leads to a shift of water into the intracellular compartment that prevents adequate refilling of the intravascular space. This intracellular movement of

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