title: Dialysate Composition for Hemodialysis: Changes and Changing Risk.
abstract: Dialysate composition is a critical aspect of the hemodialysis prescription. Despite this, trial data are almost entirely lacking to help guide the optimal dialysate composition. Often, the concentrations of key components are chosen intuitively, and dialysate composition may be determined by default based on dialysate manufacturer specifications or hemodialysis facility practices. In this review, we examine the current epidemiological evidence guiding selection of dialysate bicarbonate, calcium, magnesium, and potassium, and identify unresolved issues for which pragmatic clinical trials are needed.
authors.affiliation: Division of Nephrology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Rita L
authors.initials: RL
authors.lastname: McGill
authors.affiliation: Division of Nephrology, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Weiner
mesh_terms: D001639:Bicarbonates / Q000008:administration & dosage / Q000378:metabolism; D002118:Calcium / Q000008:administration & dosage / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D015312:Hemodialysis Solutions / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D008274:Magnesium / Q000008:administration & dosage / Q000378:metabolism; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D020380:Needs Assessment; D011188:Potassium / Q000008:administration & dosage / Q000378:metabolism; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D012964:Sodium / Q000008:administration & dosage / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D001639:Bicarbonates; D015312:Hemodialysis Solutions; D012964:Sodium; D008274:Magnesium; D011188:Potassium; D002118:Calcium