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Acetate‐Free Biofiltration: A Viable Alternative to Bicarbonate Dialysis
Author(s) -
Santoro Antonio,
Ferrari Giuseppe,
Spongano Marco,
Badiali Fabio,
Zucchelli Pietro
Publication year - 1989
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.1525-1594.1989.tb01561.x
Subject(s) - bicarbonate , chemistry , sodium bicarbonate , acid–base homeostasis , metabolic acidosis , dialysis , acid–base reaction , acidosis , sodium , biofilter , acid–base imbalance , potassium , chromatography , medicine , biochemistry , environmental engineering , organic chemistry , engineering
Abstract: Eight patients were studied during four sessions of acetate‐free biofiltration (AFBF). AFBF is a new dialysis technique with no base replacement agents in the dialysate and with the addition in postdilution mode of bicarbonate (HCO 3 ) solution directly into the extracorpo‐real blood circuit. In this study the effects on acid‐base balance of different infusions of sodium bicarbonate (NaHCO3) ranging from 751 to 1,002 mEq per session was evaluated. There were significant positive correlations between the HCO 3 infused and net HCO 3 gained (r = 0.776, p < 0.0001) and between HCO 3 infused and plasma intratreatment HCO 3 changes (n = 0.562, p < 0.001). Stepwise multiple linear regression analysis demonstrated that HCO 3 infused and plasma predialysis HCO 3 values played the major role in HCO 3 balance in AFBF. The best correction of metabolic acidosis was obtained with the infusion of 900–1,000 mEq of HCO 3 . The use of substitution fluid with 145 mEq/L of Na concentration avoids the risk of a positive intratreatment Na balance.