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Related Experiment Videos

Lactate versus bicarbonate on-line hemofiltration: a comparative study

R Marangoni1, F Civardi, F Masi

  • 1Nephrology and Dialysis Unit, Ospedale Caduti Bollatesi, Bollate, Italy.

Artificial Organs
|June 1, 1995
PubMed
Summary
This summary is machine-generated.

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Bicarbonate hemofiltration (HF) significantly increased bicarbonate and decreased potassium levels in uremic patients compared to lactate HF. These effects were transient, with no significant differences after 68 hours.

Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Biochemistry

Background:

  • Chronic anuric uremic patients require renal replacement therapy.
  • Hemofiltration (HF) is a common treatment modality.
  • The type of substitution fluid used in HF can impact patient biochemistry.

Purpose of the Study:

  • To compare the biochemical and hemodynamic effects of lactate-based versus bicarbonate-based hemofiltration in chronic anuric uremic patients.
  • To assess the impact of different HF fluids on electrolyte and acid-base balance.

Main Methods:

  • Six chronic anuric uremic patients participated in a crossover study.
  • Patients underwent 3 months of lactate HF and 3 months of bicarbonate HF.
  • Plasma and ultrafiltrate parameters, hemodynamics (HR, MAP), and echocardiography were monitored.

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Main Results:

  • Bicarbonate HF led to a significant increase in plasma HCO3- and a decrease in plasma K+ compared to lactate HF.
  • These biochemical changes were detectable up to 44 hours post-treatment but not at 68 hours.
  • Transient increases in plasma pH and PCO2 were observed during bicarbonate HF.

Conclusions:

  • Bicarbonate hemofiltration offers distinct advantages in correcting acid-base balance and managing potassium levels in uremic patients compared to lactate hemofiltration.
  • The biochemical benefits of bicarbonate HF are largely transient, normalizing by the end of the interdialytic period.
  • Further research may explore long-term impacts and optimal HF fluid selection.