| Theme | Reconsideration of standard hemodialysis: What is the optimal prescription and management for each patient? | |
|---|---|---|
| Title | The optimal composition for dialysate and substitution fluid | |
| Publish Date | 2019/08 | |
| Author | Tsutomu Kuno | Ikebukuro Kuno Clinic |
| [ Summary ] | It was discussed the optimal dialysate (substitution fluid) composition for standard hemodialysis (including online HDF). The level of dialysate sodium concentration will continue to be 140 mEq/L as a standard. On the other hand, the concentration of dialysate potassium is currently 2.0 mEq/L, the appearance of a dialysate set slightly higher than 2.0 mEq/L is expected in consideration of the induction of arrhythmia due to excessive potassium removal. The dialysate Ca concentration differs between the acetate-containing bicarbonate dialysate and the citric acid-containing acetate-free dialysate, and it is thought that around at the 2.75 mEq/L and at the 3.0 mEq/L will be the mainstream, respectively. With regard to the concentration of Mg in dialysate, the appearance of a dialysate set slightly higher than the present is expected from the view of prognosis in the patients. As for dialysate glucose concentration, there is no clear evidence and it is a future subject. |
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