Abstract: 【Abstract】 Objective Aortic stiffness, as evaluated by pulse wave velocity (PWV), is an independent predictor for all-cause mortality and cardiovascular mortality in hemodialysis (HD) patients. In general population, dietary salt loading increases PWV significantly, and lower sodium intake decreases PWV. In this study, we investigated whether the increase of sodium removal during dialysis by lower sodium concentration in dialysate could improve arterial stiffness in HD patients.  Methods A total of 16 stable HD patients without chronic volume overload were enrolled. After one month period of dialysis using routine dialysate (138 mmol/L sodium), patients were treated with dialysate of lower sodium concentration (136 mmol/L sodium) in HD for 4 months, without change of instructions about dietary sodium control. During the study period, dry weight was adjusted monthly with the help of bioimpedance spectroscope to maintain post-dialysis volume status in a steady state. PWV and 44-hour ambulatory blood pressure were measured. Results After the treatment for 4 months, PWV significantly decreased from 12.61±2.30 to 11.74±2.65 m/s (P=0.005). The 44-hour systolic and diastolic blood pressures were significantly lower than those at baseline (-10 mmHg and -6 mmHg, respectively), without change of post-dialysis volume parameters. Interdialytic weight gain decreased slightly from 2.89±0.66 to 2.67±0.63 kg (P=0.051). Conclusion Lower sodium concentration in dialysate improves arterial stiffness and blood pressure in HD patients. 

Key words: Arterial stiffness, Dialysate sodium, Hemodialysis