[Bicarbonate dialysis: comparative study of its long-term effects].
Changes in blood bicarbonate, phosphate and lipid were followed up on 9 patients as they are dialyzed with an acetate containing dialysate (AC) during 2 years and with a bicarbonate containing dialysate (BC) during 2 more years. The mean (+/- SD) predialysis concentration of blood bicarbonate was 23.11 +/- 1.09 mmol/L on AC period and 26.72 +/- 1.26 mmol/L on BC period. The new bicarbonate concentration steady state was reached with a delay of about 3 months. The mean (+/- SD) predialysis phosphate concentration was lower during BC period (1.73 +/- 0.17 vs 1.95 +/- 1.26 mmol/L). Although the changes were not significant, less aluminium hydroxide (4.8 +/- 0.8 vs 6.0 +/- 1.3 g per day) was necessary to control blood phosphate during BC period. The most striking changes in this long term study was the tolerance of the patients on bicarbonate dialysis, where hypotension episodes and muscles cramps were reduced by 50% and headache, nausea and vomiting disappeared almost completely. Conversely, no significant changes in lipid status with changing dialysate could be found. The results of this long term study provide strong support for promoting bicarbonate containing dialysate for all hemodialyzed patients.
D000085:Acetates / Q000097:blood / Q000494:pharmacology; D001639:Bicarbonates / Q000097:blood* / Q000494:pharmacology; D006801:Humans; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis; D013997:Time Factors
D000085:Acetates; D001639:Bicarbonates; D010710:Phosphates
Dialyse au bicarbonate: étude comparative des effets à long terme.