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Correcting Acidosis during Hemodialysis: Current Limitations and a Potential Solution.
David Tovbin1, Richard A Sherman2
1Department of Nephrology, Ha-Emek Medical Center, Afula, Israel.
Seminars in Dialysis
|November 24, 2015
Summary
Correcting acidosis in hemodialysis patients is crucial for preventing mineral bone disease. A novel approach using decreasing dialysate bicarbonate may improve acidosis management during hemodialysis while minimizing alkalosis.
Area of Science:
- Nephrology
- Biochemistry
Background:
- Acidosis in hemodialysis (HD) patients has detrimental catabolic and pro-inflammatory effects.
- Acidosis correction is vital for limiting mineral bone disease (MBD).
- Oral base therapy is limited by increased medication and sodium intake.
Purpose of the Study:
- To explore alternative strategies for correcting acidosis during hemodialysis.
- To address limitations of fixed dialysate bicarbonate concentrations causing pre-HD acidosis and intra-dialytic alkalosis.
Main Methods:
- Investigated the potential of a decreasing dialysate bicarbonate concentration during HD.
- Considered theoretical evidence and existing data supporting this approach.
Main Results:
- A decreasing dialysate bicarbonate strategy may correct acidosis effectively.
- This method has the potential to limit intra-dialytic alkalosis.
Conclusions:
- A decreasing dialysate bicarbonate concentration is a promising strategy for managing acidosis in HD patients.
- This approach offers an alternative to oral therapy, reducing medication and sodium burden.
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