When I started on dialysis I studied the process and realised that it was a chemical process along with drawing excess fluid out of the body. The incidence of hypotension/ hypoglycaemia etc was giving me lots of question marks. Once I happened to ask the dialysis technician on what settings he makes in the machine while starting the process and he told me about the sodium etc. I understood that a combination of sodium and fluid levels in the body result in hypotension. In my case since I am a trekker it is even more critical to understand how it works. I tried various combinations and activities and basis that this is some of the results that I have arrived at.
Sodium is a very important electrolyte in our body. It is also an important component of our food. For those on dialysis and specifically those who dont pass any urine, it is critical to control sodium levels in the blood.
For those who live an active life it is even more important. I have tried a lot of combinations in my case ( at times risky but got away with it) and today I am in a position to maybe list what would work in most cases. This is a thumb rule and would therefore change from person to person.
The logic behind the same is basically how much of sweat is expected to be lost from the body during the time before the next round of dialysis.
The more the amount of sweat expected the more sodium that is expected to be lost. This would also be a balance between the fluid loss and sodium loss.
Typically when there is expected to be a higher loss of fluid / sodium (typically before a difficult trek) the sodium that works best for me is around 138-139. In the peak of summer as well (we dont normally trek during the peak of summer) this is the case. If its a long trek then maybe 140.
On other occasions, the best sodium level that works for me is around 136-137
In winter 136 works best.
Winter treks mean same amount of sweat and sodium loss so just before a winter trek the best level would be around 139
So during the process of dialysis the range of Sodium can be kept at around 136-140 depending on the amount of sodium/fluid loss that is expected to happen before the next cycle of dialysis.
This would however vary on body weight and the propensity to consume foods with sodium content during the intra cycle days.
I guess each dialysor should study such tendencies in their individual cases and understand how sodium control during dialysis helps in living a life that is more active and hence more meaningful.