title: Effect of bicarbonate-containing dialysate on chronic hemodialysis patients: a comparative study.
abstract: Changes in pH and blood gases were studied during hemodialysis with both acetate and bicarbonate dialysates. During acetate dialysis, PaO2 and PaCO2 decreased significantly (P less than 0.05) from 101 +/- 2 to 93 +/- 3 mmHg and from 34.4 +/- 1.0 to 31.8 +/- 0.9 mmHg, respectively, whereas during bicarbonate dialysis neither parameter changed significantly. The final pH was 7.45 +/- 0.01 during acetate dialysis and 7.50 +/- 0.02 during bicarbonate dialysis. Plasma bicarbonate rose immediately and progressively from 18.9 +/- 0.8 to 26.8 +/- 0.9 mmol/L with bicarbonate dialysis, whereas the increase was moderate, from 19.6 +/- 0.6 to 22.3 +/- 0.5 mmol/L, with acetate dialysis. These data indicate that dialysis-induced hypoxemia was prevented and correction of acidosis was more adequate with bicarbonate dialysis. During a two-year period on bicarbonate dialysis, total cholesterol, HDL-cholesterol, and triglycerides did not change significantly when compared to acetate dialysis. The most striking change was the increased tolerance to dialysis with bicarbonate dialysis, which included a 50% reduction in hypotensive episodes and muscle cramps and an almost complete absence of headache, nausea, and vomiting.
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D019342:Acetic Acid; D001639:Bicarbonates / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D002784:Cholesterol / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D006435:Renal Dialysis; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D000085:Acetates; D001639:Bicarbonates; D014280:Triglycerides; D002784:Cholesterol; D019342:Acetic Acid