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Acetate-free biofiltration: hemodiafiltration with base-free dialysate
P Zucchelli1, A Santoro, G Ferrari
1Divisione di Nefrologia e Dialisi Malpighi, Policlinico S. Orsola-Malpighi, Bologna, Italy.
Blood Purification
|January 1, 1990
Summary
Acetate-free biofiltration (AFBF) offers a safe and effective alternative to bicarbonate dialysis. This novel technique successfully corrects uremic acidosis with improved patient outcomes and reduced treatment time.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Biochemistry
Background:
- Bicarbonate dialysis offers clinical benefits but requires complex hardware.
- Acetate hemodialysis presents challenges in acid-base balance management.
- Existing dialysis methods necessitate careful consideration of base replacement agents.
Purpose of the Study:
- To introduce and evaluate acetate-free biofiltration (AFBF) as a novel dialysis technique.
- To assess the efficacy of AFBF in correcting uremic acidosis.
- To compare the safety and efficiency of AFBF with conventional hemodialysis.
Main Methods:
- AFBF, a modified hemodiafiltration technique, was employed.
- Bicarbonate solution was infused post-dialysis without base agents in the dialysate.
- An acute phase study (8 patients) and a chronic phase study (4 patients) were conducted.
Main Results:
- Optimal correction of uremic acidosis was achieved with 900-1,000 mEq bicarbonate infusion during a 3-hour AFBF session.
- A significant positive correlation was observed between infused and gained bicarbonate.
- Chronic AFBF led to increased plasma bicarbonate levels and a reduction in weekly treatment time with stable chemistries and low intradialytic hypotension.
Conclusions:
- AFBF is a safe, easy-to-use alternative to bicarbonate dialysis.
- The technique effectively corrects uremic acidosis and improves patient stability.
- AFBF offers advantages including reduced maintenance, absence of pyrogen reactions, and lower cost.