Hemodialysis with Bicarbonate Containing Dialysate

Abstract

In chronic hemodialysis (HD) patients, hemodynamic and clinical effects of HD with acetate containing dialysate were evaluated and compared with those of HD with bicarbonate containing dialysate. In the end of HD with the acetate dialysate, an increase in the limb blood flow, a decrease in total vascular resistance, a fall in mean BP and a rise in PEP/ET ratio were observed significantly. This vasodilating effect was not found after HD with the bicarbonate dialysate. A vasodilating effect and a rise in PEP/ET of acetate were comfirmed in the infusion test, too. Following infusion of sodium acetate, a significant fall in arterial PO² was also observed. Side effects, such as hypotension, nausea and vomiting, discomfort of the chest, and abdominal pain, observed frequently during the acetate HD were significantly improved by the bicarbonate HD.