title: [Biofiltration without buffering substances in the dialysate].
abstract: A new hemodiafiltration technique, acetate free biofiltration (AFB), has been recently introduced in the treatment of chronic uremia. It is performed with a buffer free dialysate and a simultaneous infusion in post-dilution mode of a sodium bicarbonate solution (concentration 145-166 mEq/l; infusion rate 1.2-2 l/h). A polyacrylonitrile hollow fiber AN69 HF 1.2 sqm dialyzer is employed. In acute studies pCO2 remains stable throughout the treatment, as well as pCO2. We have found a significant inverse correlation between delta[HCO3-] pre and post treatment and basal [HCO3-] (r = -0.88; p less than 0.001), with an excellent correction of uremic acidosis, avoiding post dialytic alkalosis. Our long term experience on 6 patients followed up to 31 months, allows us to consider AFB as a feasible and safe treatment, offering a good correction of uremic acidosis and an excellent hemodynamic tolerance. We propose AFB as a competitive technique with respect to bicarbonate hemodialysis, hemodiafiltration and standard biofiltration.
authors.affiliation: Università di Torino, Istituto di Nefro-Urologia.
authors.forename: F
authors.initials: F
authors.lastname: Quarello
authors.forename: R
authors.initials: R
authors.lastname: Boero
authors.forename: G
authors.initials: G
authors.lastname: Martina
authors.forename: M
authors.initials: M
authors.lastname: Formica
authors.forename: C
authors.initials: C
authors.lastname: Guarena
authors.forename: G
authors.initials: G
authors.lastname: Beltrame
authors.forename: B
authors.initials: B
authors.lastname: Scalzo
authors.forename: G
authors.initials: G
authors.lastname: Forneris
authors.forename: G
authors.initials: G
authors.lastname: Piccoli
mesh_terms: D000138:Acidosis / Q000628:therapy; D000471:Alkalosis / Q000517:prevention & control; D001639:Bicarbonates / Q000008:administration & dosage; D002021:Buffers; D015314:Dialysis Solutions; D015312:Hemodialysis Solutions; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012964:Sodium / Q000008:administration & dosage; D017693:Sodium Bicarbonate; D014511:Uremia / Q000150:complications / Q000628:therapy*
chemical_list: D001639:Bicarbonates; D002021:Buffers; D015314:Dialysis Solutions; D015312:Hemodialysis Solutions; D017693:Sodium Bicarbonate; D012964:Sodium
vernacular_title: La biofiltrazione senza sostanze tampone nel dialisato.