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[On-line hemodiafiltration without acetate].

F Pizzarelli1, T Cerrai, G Ferro

  • 1U.O. di Nefrologia e Dialisi, Ospedale S. Maria Annunziata, Florence. fpizzarelli@yahoo.com

Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
|March 5, 2005
PubMed
Summary
This summary is machine-generated.

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Eliminating acetate from hemodiafiltration dialysate significantly reduces acetate levels in patients. This approach prevents acetate gain during convective treatments and may mitigate cytokinin activation.

Area of Science:

  • Nephrology
  • Biochemistry

Context:

  • On-line hemodiafiltration (HDF-OL) involves reinfusing dialysate containing bicarbonate and acetate.
  • The impact of acetate gain during high-volume convective treatments in HDF-OL is not well understood.

Purpose:

  • To investigate the trend of acetatemia during HDF-OL with acetate-containing dialysate.
  • To evaluate the clinical significance of acetate gain from infused fluids.

Summary:

  • Pilot study with 12 patients comparing HDF-OL with and without 3 mmol/L acetate in substitution fluid.
  • Acetate gain was significant (75 mmol average) when using acetate-containing dialysate, increasing acetatemia 5-6 fold.
  • Acetate-free HDF-OL prevented this increase, resulting in lower IL-6 levels post-treatment.

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Impact:

  • Acetate gain during HDF-OL is significant and can potentially trigger cytokinin activation.
  • Removing acetate from dialysate cancels acetate gain and associated inflammatory responses.
  • Adjusting bicarbonate levels in acetate-free dialysate can compensate for the absence of acetate.