[Acetate-free hemodialysis: what does it mean?].
Substituting bicarbonate by acetate in dialysis fluids has been proposed for avoiding precipitation of calcium and magnesium carbonates. However, acetate hemodialysis has been abandoned because of deleterious effects of acetate. Conventional bicarbonate hemodialysis is not totally acetate-free, because 3 to 7 mEq/l of acetic acid are added to the dialysate. Acetate-free hemodialysis is possible with another acid (chlorhydric acid or citric acid) or without acid by using some techniques of low-efficiency hemodiafiltration, as acetate-free biofiltration, which avoids the deleterious effect of blood acidification into the dialyzer. In this paper, advantages and disadvantages of different techniques of acetate-free hemodialysis are discussed.
Département de biophysique, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, 75013 Paris, France. thierry.petitclerc@auraparis.org
Thierry
T
Petitclerc
Raji
R
Diab
Frank
F
Le Roy
Lucile
L
Mercadal
Jalel
J
Hmida
D000085:Acetates / Q000009:adverse effects; D001639:Bicarbonates / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D017583:Hemodiafiltration / Q000009:adverse effects / Q000379:methods*; D015312:Hemodialysis Solutions; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods; D016896:Treatment Outcome
D000085:Acetates; D001639:Bicarbonates; D015312:Hemodialysis Solutions