title: [Bioincompatibility of acetate even at low concentrations].
abstract: Over the last 20 years a large body of evidence has demonstrated that in chronic renal failure there is progressive chronic inflammation, which increases after the start of dialysis. In this phase a fundamental role is played by bioincompatibility reactions induced by contact with the different dialysis materials: membranes, plastic lines, dialysis fluids as well as contaminants present in water. Clinically evident symptoms induced by bioincompatibility reactions are usually taken into serious account by nephrologists, while more subtle chronic effects, noxious in the long term, are often underconsidered. Since the 1990s many efforts have been addressed to membrane improvement and water treatment, while there is still a lot to be done for better dialysates. Acetate dialysis is routinely used in only about 5% of patients worldwide but over 80% of patients are exposed to the lower acetate concentrations present in standard bicarbonate dialysate. These concentrations are not negligible and are able to induce chronic reactions mainly converging on the endothelium, stimulating and maintaining the atherogenesis process with important long-term implications for cardiovascular morbidity. This review presents and discusses the available data on the cellular and molecular effects induced by acetate, even at low concentrations.
authors.affiliation: SC Nefrologia Dialisi e Trapianto, Ospedale Infantile Regina Margherita, Torino, Italy. licia.peruzzi@unito.it
authors.forename: Lucia
authors.initials: L
authors.lastname: Peruzzi
authors.forename: Roberta
authors.initials: R
authors.lastname: Camilla
authors.forename: Roberto
authors.initials: R
authors.lastname: Bonaudo
authors.forename: Rosanna
authors.initials: R
authors.lastname: Coppo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Amore
mesh_terms: D000085:Acetates / Q000009:adverse effects* / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D006435:Renal Dialysis
chemical_list: D000085:Acetates