[Biofiltration without buffering substances in the dialysate].
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.
Quarello
F
F
Università di Torino, Istituto di Nefro-Urologia.
Boero
R
R
Martina
G
G
Formica
M
M
Guarena
C
C
Beltrame
G
G
Scalzo
B
B
Forneris
G
G
Piccoli
G
G
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*
D001639:Bicarbonates; D002021:Buffers; D015314:Dialysis Solutions; D015312:Hemodialysis Solutions; D017693:Sodium Bicarbonate; D012964:Sodium
La biofiltrazione senza sostanze tampone nel dialisato.