Abstract
The superiority of bicarbonate dialysis (Bi HD) over acetate dialysis (Ac HD) using a high sodium dialysate has not been established to our knowledge. We compared Bi HD to Ac HD over 6 weeks each in ten stable patients using a double-blind crossover design and a dialysate sodium concentration of 140 mEq/liter. The dialyzer, delivery system, and dialysate constituents were identical except for the substitution of Bi or Ac. Interdialytic weight gain, pre- and post-HD blood pressures, and heart rates were also comparable in the two protocols. Beginning of the week pre-HD serum Bi was greater during Bi HD than Ac HD (19.1 ± 0.9 vs. 15.1 ± 0.8 mEq/liter, P < 0.001); post HD Bi values were also higher during Bi HD. Similarly, pre-HD pH was also greater with Bi HD (7.40 ± 0.012 vs. 7.35 ± 0.001 U, P < 0.01). The number of adverse symptoms and signs were similar during each protocol (2.0 ± 0.65 for Bi HD vs. 2.5 ± 0.5 for Ac HD episodes/patient/6 weeks, NS). However, fewer therapeutic interventions were required during the Bi HD protocol (1.5 ± 0.43 vs. 3.1 ± 0.6 treatments/patient/6 weeks, P < 0.02). The ventilatory effects of the two dialysate were evaluated at the end of the 6-week course in seven of ten patients and revealed comparable declines in carbon dioxide excretion, minute ventilation, and arterial oxygen tension. In summary, these results demonstrate strikingly similar hemodynamic and ventilatory responses with the two dialysate when a higher osmolality dialysate is used. However, Bi HD was associated with a significant reduction in the number of therapeutic interventions required, and also resulted in a greater pre-HD pH and bicarbonate concentration.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 240-245 |
| Number of pages | 6 |
| Journal | Kidney International |
| Volume | 24 |
| Issue number | 2 |
| State | Published - 1983 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Nephrology
Cite this
High sodium bicarbonate and acetate hemodialysis : Double-blind crossover comparison of hemodynamic and ventilatory effects. / Henrich, William L; Woodard, T. D.; Meyer, B. D.; Chappell, T. R.; Rubin, L. J.
In: Kidney International, Vol. 24, No. 2, 1983, p. 240-245.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High sodium bicarbonate and acetate hemodialysis
T2 - Double-blind crossover comparison of hemodynamic and ventilatory effects
AU - Henrich, William L
AU - Woodard, T. D.
AU - Meyer, B. D.
AU - Chappell, T. R.
AU - Rubin, L. J.
PY - 1983
Y1 - 1983
N2 - The superiority of bicarbonate dialysis (Bi HD) over acetate dialysis (Ac HD) using a high sodium dialysate has not been established to our knowledge. We compared Bi HD to Ac HD over 6 weeks each in ten stable patients using a double-blind crossover design and a dialysate sodium concentration of 140 mEq/liter. The dialyzer, delivery system, and dialysate constituents were identical except for the substitution of Bi or Ac. Interdialytic weight gain, pre- and post-HD blood pressures, and heart rates were also comparable in the two protocols. Beginning of the week pre-HD serum Bi was greater during Bi HD than Ac HD (19.1 ± 0.9 vs. 15.1 ± 0.8 mEq/liter, P < 0.001); post HD Bi values were also higher during Bi HD. Similarly, pre-HD pH was also greater with Bi HD (7.40 ± 0.012 vs. 7.35 ± 0.001 U, P < 0.01). The number of adverse symptoms and signs were similar during each protocol (2.0 ± 0.65 for Bi HD vs. 2.5 ± 0.5 for Ac HD episodes/patient/6 weeks, NS). However, fewer therapeutic interventions were required during the Bi HD protocol (1.5 ± 0.43 vs. 3.1 ± 0.6 treatments/patient/6 weeks, P < 0.02). The ventilatory effects of the two dialysate were evaluated at the end of the 6-week course in seven of ten patients and revealed comparable declines in carbon dioxide excretion, minute ventilation, and arterial oxygen tension. In summary, these results demonstrate strikingly similar hemodynamic and ventilatory responses with the two dialysate when a higher osmolality dialysate is used. However, Bi HD was associated with a significant reduction in the number of therapeutic interventions required, and also resulted in a greater pre-HD pH and bicarbonate concentration.
AB - The superiority of bicarbonate dialysis (Bi HD) over acetate dialysis (Ac HD) using a high sodium dialysate has not been established to our knowledge. We compared Bi HD to Ac HD over 6 weeks each in ten stable patients using a double-blind crossover design and a dialysate sodium concentration of 140 mEq/liter. The dialyzer, delivery system, and dialysate constituents were identical except for the substitution of Bi or Ac. Interdialytic weight gain, pre- and post-HD blood pressures, and heart rates were also comparable in the two protocols. Beginning of the week pre-HD serum Bi was greater during Bi HD than Ac HD (19.1 ± 0.9 vs. 15.1 ± 0.8 mEq/liter, P < 0.001); post HD Bi values were also higher during Bi HD. Similarly, pre-HD pH was also greater with Bi HD (7.40 ± 0.012 vs. 7.35 ± 0.001 U, P < 0.01). The number of adverse symptoms and signs were similar during each protocol (2.0 ± 0.65 for Bi HD vs. 2.5 ± 0.5 for Ac HD episodes/patient/6 weeks, NS). However, fewer therapeutic interventions were required during the Bi HD protocol (1.5 ± 0.43 vs. 3.1 ± 0.6 treatments/patient/6 weeks, P < 0.02). The ventilatory effects of the two dialysate were evaluated at the end of the 6-week course in seven of ten patients and revealed comparable declines in carbon dioxide excretion, minute ventilation, and arterial oxygen tension. In summary, these results demonstrate strikingly similar hemodynamic and ventilatory responses with the two dialysate when a higher osmolality dialysate is used. However, Bi HD was associated with a significant reduction in the number of therapeutic interventions required, and also resulted in a greater pre-HD pH and bicarbonate concentration.
UR - http://www.scopus.com/inward/record.url?scp=0020603285&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0020603285&partnerID=8YFLogxK
M3 - Article
C2 - 6314029
AN - SCOPUS:0020603285
VL - 24
SP - 240
EP - 245
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 2
ER -