Effect of dialysis on lipid metabolism in chronic renal failure - acetate versus bicarbonate

The effect of two dialysate buffer bases--acetate and bicarbonate - on lipid profile in chronic renal failure was studied in nine patients on maintenance hemodialysis, employing a double crossover method. The total cholesterol level and LCAT crossover method. The total cholesterol level and LCAT activity significantly decreased during acetate dialysis compared to bicarbonate dialysis (p less than 0.05), although the HDL-cholesterol level remained low during both modalities of dialysis. Other serum lipids or lipoproteins, such as triglycerides, free fatty acids, phospholipids, VLDL and LDL, showed no manifest variations relevant to the change of the dialysate buffer base. Likewise, the levels of apoproteins A and C were not significantly affected by the difference of dialysate. No evidence was obtained for a more beneficial effect of the bicarbonate dialysis compared to the acetate bath on lipid metabolism of the dialyzed patients.