Effect of acetate and bicarbonate dialysis on cardiac performance and transmural myocardial perfusion in patients with renal failure.

The object of the present study was to assess the haemodynamic changes measured by impedance cardiography during acetate and bicarbonate dialysis in uraemic patients without cardiovascular diseases. It was demonstrated that the cardiac output increased significantly after 60 minutes during acetate dialysis compared with bicarbonate dialysis while the peripheral resistance decreased significantly during acetate dialysis. As estimated by the diastolic systolic pressure time index ratio myocardial perfusion fell significantly following acetate dialysis as compared to bicarbonate dialysis. It is concluded that the work of the heart increases during acetate dialysis. This involves risk of myocardial hypoperfusion. It is therefore recommended that bicarbonate dialysis is the choice for patients with unstable circulation and/or ischaemic heart disease.