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Hemodynamic Changes During Acetate and Bicarbonate Hemodialysis
Author(s) -
Leenen Frans H. H.,
Buda Andrew J.,
Smith Donna L.,
Farrel Susan,
Levine David Z.,
Uldall P. Robert
Publication year - 1984
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1984.tb04316.x
Subject(s) - bicarbonate , hemodynamics , hemodialysis , cardiology , medicine , chemistry
In a crossover, double‐blind comparison, circulatory changes induced by hemodialysis with bicarbonate versus acetate dialysate were evaluated at the first exposure as well as after 2 weeks of acclimatization to each dialysate. Hemodialysis with bicarbonate dialysate resulted in only minor changes in blood pressure and left ventricular (LV) function as assessed by M‐mode echocardiography. In contrast, the first exposure to acetate resulted in significant decreases in systolic (30 mm Hg) and diastolic (17 mm Hg) blood pressure as well as in LV end‐diastolic and end‐systolic dimensions (5–6 mm) and a rise in ejection fraction. After acclimatization, tolerance developed for the arterial vasodilatory effects of acetate, but not for the venous vasodilatory effect (persistent decrease in LV end‐diastolic dimension). These results indicate that some of the circulatory changes induced by hemodialysis may be related more to the acetate infused than to fluid losses or relative autonomic insufficiency