Efficacy of acetate-free dialysate for the treatment of patients with acute kidney injury

Abstract

We conducted a prospective, randomized study to compare acetate-free dialysate with conventional acetate-containing dialysate for the treatment of acute kidney injury (AKI). Forty patients with AKI who required intermittent renal replacement therapy (IRRT) were treated with either acetate-free dialysate (acetate-free group; AF-group) or acetate-containing dialysate (acetate-containing group; AC-group). IRRT, including hemodialysis and hemodiafiltration, was performed with a dialysate flow rate of 500mL/min. Baseline characteristics of the patients in the two treatment groups were similar. The duration of renal recovery was significantly shorter in the AF-group than in the AC-group (19.0±5.8 vs. 14.6±9.4 days, respectively; p＜0.05). The total number of treatments per patient was significantly lower in the AF-group compared to the AC-group (6.9±3.1 vs. 8.9±3.2 sessions/patient, respectively；p＜0.05). Similarly, hospital stay length was significantly shorter in the AF-group than in the AC-group (28.2±8.3 vs. 36.8±12.1 days, respectively；p＜0.05). The pH and bicarbonate concentrations were significantly higher in the AF-group than in the AC-group during the study period. Our results suggest that compared with conventional acetate-containing dialysate, acetate-free dialysate may accelerate renal recovery in patients with AKI.