ON - LINE HAEMODIAFILTRATION WITH AND WITHOUT ACETATE
https://doi.org/10.24884/1561-6274-2009-13-2-50-54
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. 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. 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. 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.
About the Authors
F. Pizzarelli
SM Annunziata Hospital
Italy
Italy
Dr Francesco Pizzarelli, Head o f Nephrology Unit
Via dell’ Antella 58, 50011 Antella-Firenze, Italy
T. Cerrai
SM Annunziata Hospital
Italy
Italy
Nephrology Unit
P. Dattolo
SM Annunziata Hospital
Italy
Italy
Nephrology Unit
G. Ferro
SM Annunziata Hospital
Italy
Italy
Nephrology Unit
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Review
For citations:
Pizzarelli F., Cerrai T., Dattolo P., Ferro G. ON - LINE HAEMODIAFILTRATION WITH AND WITHOUT ACETATE. Nephrology (Saint-Petersburg). 2009;13(2):50-54. (In Russ.) https://doi.org/10.24884/1561-6274-2009-13-2-50-54
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