Evaluation of acetate tolerance during highly efficient hemodialysis

Acetate clearance was found to approximate bicarbonate clearance and to be 10% lower than urea clearance under single pass in vitro conditions. Plasms acetate concentrations were significanlty higher in pre-dialysis samples than in control subjects and rose during hemodialysis to a wide range of post-dialysis levels. In 17% of patients plasma acetate exceeded 9.5 mM/L and range to 21.6 mM/L. The cause for this apparent acetate intolerance is probably multifactorial, since severe hyperacetatemia is not a constant finding for any specific patient. Correction of pre-dialysis acidosis may be impaired by acetate accumulation.