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On-line haemodiafiltration with and without acetate.
- Source :
-
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2006 Jun; Vol. 21 (6), pp. 1648-51. Date of Electronic Publication: 2006 Feb 07. - Publication Year :
- 2006
-
Abstract
- Background: In patients on on-line convective treatments, given the considerable quantity of dialysis fluid re-infused, the small amount of acetate present in bicarbonate dialysis fluid as a pH stabilizing factor may allow a significant transfer of that anion to the patient, possibly inducing cytokine activation.<br />Methods: To verify this hypothesis, we performed on-line haemodiafiltration (OL-HDF) with (3 mmol/l) and without acetate in dialysis fluid in a cross-over randomized order on 12 prevalent patients.<br />Results: In comparison with the pre-treatment values, plasma acetate levels were unchanged during and after acetate-free OL-HDF, while they were 5-6 times higher in the course of OL-HDF containing acetate in dialysis fluid; plasma acetate levels returned to basal values 2 h after the end of the procedure. The total increase of bases in the patient attributable to acetate was 36%. Plasma bicarbonate values at the end of treatment were significantly lower in treatments without acetate, as compared to those with acetate. Interleukin-6 plasma levels were super-imposable at the beginning and in the course of the two methods compared, but there was a tendency towards a greater increase at an interval of 2 h following OL-HDF with acetate.<br />Conclusions: Our preliminary results confirm the assumption that body gain of acetate is particularly high in convective treatments, while acetate-free OL-HDF slows down acetate burden. Clinical advantages due to these effects should be evaluated in properly designed prospective studies.
- Subjects :
- Acetates pharmacology
Acetates therapeutic use
Aged
Bicarbonates blood
Bicarbonates therapeutic use
Blood Gas Analysis
Cross-Over Studies
Cytokines drug effects
Electrolytes blood
Female
Hemodialysis Solutions pharmacology
Humans
Interleukin-6 blood
Kinetics
Male
Middle Aged
Online Systems
Acetates blood
Hemodiafiltration methods
Hemodialysis Solutions chemistry
Subjects
Details
- Language :
- English
- ISSN :
- 0931-0509
- Volume :
- 21
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Publication Type :
- Academic Journal
- Accession number :
- 16464887
- Full Text :
- https://doi.org/10.1093/ndt/gfk093