The Japanese Journal of Clinical Dialysis Vol.35 No.2(12)

Theme Electrolyte and acid-base disorders in dialysis patients
Title Now of acetate free dialysate
Publish Date 2019/02
Author Tsutomu Kuno Ikebukuro Kuno Clinic
[ Summary ] As advantages of acetate-free citrate containing bicarbonate dialysate (AF-BCD), hemodynamic stability, improved nutritional status, anti-inflammatory effects, reduction of fatigue level of the patients, etc are reported. On the other hand, the concentration of bicarbonate ion is set at 35 mmol/L, therefore in the elderly patients and patients with low intake of dietary protein, there is concern of excessive alkalization and it is desirable to periodically monitor acid-base equilibrium by blood gas analysis. Regarding dialysate Ca concentration, it is necessary to understand the characteristics of duality of high and low Ca and to use it. Acetate-free biofiltration (AFBF) contains neither acetate nor citrate. It has an advantage that over alkalization is avoided, because sodium bicarbonate solution is injected according to individual patients, but the personal HDF machine is required.
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