醋酸盐和碳酸氢盐透析液对稳定的慢性透析患者的影响。

Effects of acetate and bicarbonate dialysate in stable chronic dialysis patients.

作者信息

Hakim R M, Pontzer M A, Tilton D, Lazarus J M, Gottlieb M N

出版信息

Kidney Int. 1985 Sep;28(3):535-40. doi: 10.1038/ki.1985.161.

DOI:10.1038/ki.1985.161

Abstract

The effects of acetate and bicarbonate dialysate on the biochemical and clinical parameters of 16 stable chronic hemodialysis patients were investigated in a double-blind crossover study. A central delivery system was used for both types of dialysates with identical sodium concentrations (138 mEq/liter) and osmolality in a single-pass dialysate flow. The results indicate that dialysis with bicarbonate leads to significantly less hypoxemia (P less than or equal to 0.001) and hypotensive episodes (P less than or equal to 0.002) than with acetate. Pre- to post-dialysis blood pressure changes were also more marked during acetate dialysis. Older patients with recurrent hypotension on acetate benefit most from bicarbonate dialysate. This group of patients appears to metabolize acetate more slowly and has a significantly lower post-dialysis bicarbonate concentration (P less than or equal to 0.005) than asymptomatic patients during dialysis with acetate dialysate.

摘要

在一项双盲交叉研究中，对16例稳定的慢性血液透析患者，研究了醋酸盐和碳酸氢盐透析液对其生化及临床参数的影响。两种透析液均通过中央输送系统提供，在单通道透析液流中具有相同的钠浓度（138 mEq/升）和渗透压。结果表明，与醋酸盐透析相比，碳酸氢盐透析导致的低氧血症（P≤0.001）和低血压发作（P≤0.002）明显更少。在醋酸盐透析期间，透析前至透析后的血压变化也更明显。醋酸盐透析时反复出现低血压的老年患者从碳酸氢盐透析液中获益最大。与使用醋酸盐透析液透析期间无症状的患者相比，这组患者似乎对醋酸盐的代谢更慢，透析后碳酸氢盐浓度明显更低（P≤0.005）。