[Personal preparation of bicarbonate solutions--cost comparison and quality control]

Haemodialysis with bicarbonate dialysate is well established in the treatment of chronic renal failure. The costs of bicarbonate haemodialysis are higher than acetate haemodialysis. Commercially available bicarbonate solutions are sold from AS 129.- to AS 189.- per 8 litre canister (December 1987). The self-prepared solution contains 650 g bicarbonate (for AS 8.-) in 8 litres of deionized water. In 10 patients on regular dialysis treatment haemodialysis were performed with both commercially available and self-prepared solutions for a 3 week period. Blood and dialysate samples were obtained before and 10 minutes, 1 h, 2 h, 3 h and 4 h after starting haemodialysis. Osmolality, Na+, K+, Cl-, pO2, pCO2 and pH were measured in the dialysate and in the serum, as well as serum lactate levels. There were no significant differences and the biochemical changes were similar with both preparations. In our centre with about 4000 bicarbonate dialyses yearly, AS 500,000.- to AS 700,000.- could be saved by self preparation of the dialysate.