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- Title
Acid-base changes and acetate metabolism during routine and high-efficiency hemodialysis in children.
- Authors
Kaiser, Bruce A.; Potter, Donald E.; Bryant, Ralph E.; Vreman, Hendrick J.; Weiner, Michael W.
- Abstract
Changes m acid-base status and plasma acetate concentrations were studied in eight children during 11 hemodialysis sessions. During dialysis, the blood bicarbonate concentration fell (20.5 ± 0.7 to 19.6 ± 0.8 mEq/liter), the Pco2 fell (33.4 ± 0.8 to 27.5 ± 1.4 mm Hg), and the pH rose (7.42 ± 0.01 to 7.48 ± 0.02). During the hour after dialysis, the bicarbonate concentration rose to normal (23.4 ± 0.7 mEq/liter), the Pco2 rose (32.8 ± 0.8 mm Hg), and the pH remained unchanged. The half-life of plasma acetate, measured after dialysis, was 8.7 rain. During five ‘high-efficiency’ dialysis sessions (urea clearance, > 3.0 ml/min/kg), blood bicarbonate concentration fell 3.2 mEq/liter, Pco2 fell 8.7 mm Hg, and plasma acetate rose to 7.51 mmoles/liter, whereas during six ‘routine efficiency’ dialysis sessions (urea clearance, 1.5 to 3.0 ml/min/kg), blood bicarbonate rose 1.0 mEq/liter, Pco2 fell 36 mm Hg, and plasma acetate rose to 3.52 mmoles/liter. At 1 hour after the end of dialysis, blood bicarbonate, Pco2, and plasma acetate concentrations were similar in the two groups. Clinical problems occurred more frequently in the high-efficiency group during dialysis although the difference was not significant. The data indicate that (1) dialysis with acetate buffer effectively corrects predialysis metabolic acidosis, (2) although children have a high rate of acetate metabolism, during high-efficiency dialysis this rate is exceeded by the influx of acetate, and acid-base abnormalities occur. These abnormalities are transient but may cause clinical problems.
- Subjects
ACID-base imbalances in children; METABOLIC disorders in children; JUVENILE diseases; BODY fluid disorders; ACETATES; HEMODIALYSIS; BLOOD filtration
- Publication
Kidney International, 1981, Vol 19, Issue 1, p70
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1981.9