Higher Weight Gain Between HD Sessions and Volume Overload

Diabetic patients were reported to gain 30-50% more interdialytic weight than nondiabetics (12), and increased interdialytic weight has been independently associated with decreased survival of diabetic ESRD patients treated with HD (37). The underlying mechanism is unclear and it might be correlated with the degree of hyperglycemia (38) or a higher intracellular sodium content producing increased thirst and further water intake (39). The resulting volume overload requires further UF, which results in both hypotensive episodes and painful muscle cramps.

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