Biofiltration with buffer-free dialysate.
The presence of acetate in the dialysate appears to be superfluous in the new depurative technique indicated as biofiltration, which consists in a standard hemodialysis with high ultrafiltration combined with the reinfusion of 3-4 1/2 liters of solution containing bicarbonate. The presence of acetate could in fact be contraindicated by a number of potential side effects, metabolic, cardiovascular and biological. Hence, starting from the consideration that in standard biofiltration a buffer is already infused directly as bicarbonate, we tried to overcome the potential hazards of the acetate-containing bath simply by using a dialysate without acetate and by increasing the concentration of bicarbonate in the reinfusate. A cumulative clinical experience of 20 months in 4 patients proved the feasibility and safety of the technique and suggests further advantages over standard biofiltration (better control of acid-base equilibrium, better cardiovascular stability.
D000085:Acetates / Q000008:administration & dosage; D000328:Adult; D001639:Bicarbonates / Q000008:administration & dosage; D001769:Blood; D002021:Buffers; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D006435:Renal Dialysis; D012212:Rheology; D012964:Sodium; D014462:Ultrafiltration / Q000295:instrumentation / Q000379:methods*
D000085:Acetates; D001639:Bicarbonates; D002021:Buffers; D012964:Sodium