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Intraerythrocytic pH variations during hemodialysis: a 31P NMR study
Kidney International
|March 1, 1989
Summary
Acetate hemodialysis causes a significant drop in intraerythrocytic pH (pHi) in patients, unlike bicarbonate hemodialysis. This intracellular pH decrease, potentially due to CO2/bicarbonate shifts, varies between patients and may explain adverse effects.
Area of Science:
- Nephrology
- Physiology
- Biochemistry
Background:
- Patients undergoing hemodialysis often present with altered intraerythrocytic pH (pHi) and extracellular pH (pHo) compared to healthy individuals.
- Understanding pH dynamics during dialysis is crucial for patient management and mitigating complications.
Purpose of the Study:
- To compare the effects of bicarbonate and acetate hemodialysis on intraerythrocytic pH (pHi) and extracellular pH (pHo).
- To investigate the underlying mechanisms of pH changes during acetate hemodialysis.
Main Methods:
- Measurement of intraerythrocytic pH (pHi) and extracellular pH (pHo) in patients before and during hemodialysis sessions.
- Comparison of pH variations between bicarbonate and acetate hemodialysis modalities.
Main Results:
- Bicarbonate hemodialysis led to a continuous increase in both pHi and pHo, approaching normal values.
- Acetate hemodialysis initially decreased pHi significantly while causing only a slight decrease in pHo.
- The observed intracellular pH drop during acetate hemodialysis appears to originate from intracellular CO2/bicarbonate equilibrium shifts and shows interpatient variability.
Conclusions:
- Acetate hemodialysis induces a distinct intracellular pH decrease, potentially linked to adverse patient outcomes.
- The interpatient variability in pHi drop suggests a correlation with observed clinical problems during acetate hemodialysis.
- Bicarbonate hemodialysis offers a more stable intracellular and extracellular pH environment during treatment.