Brezis M, Brown R S
Am J Kidney Dis. 1985 Dec;6(6):425-7. doi: 10.1016/s0272-6386(85)80106-2.
A severe metabolic acidosis was produced in a patient with chronic renal failure by hemodialysis using a sorbent system to regenerate bicarbonate dialysate with an initial bicarbonate concentration of 60 mEq/L. The acidosis resolved with standard single-pass hemodialysis. In five additional patients, the bicarbonate concentration of the dialysate with the sorbent system was noted to be low and quite variable (mean +/- SD, 16.5 +/- 8.3 mEq/L, range 5 mEq/L to 39 mEq/L). The low dialysate bicarbonate failed to correct metabolic acidosis and, in fact, was capable of further lowering the serum bicarbonate. The capacity of the regenerating cartridge to release protons makes this form of dialysis a potential cause for metabolic acidosis. The safety of the sorbent system dialysis, at least in the bicarbonate mode, requires further evaluation.
在一名慢性肾衰竭患者中，通过使用吸附剂系统进行血液透析来再生初始碳酸氢盐浓度为60 mEq/L的碳酸氢盐透析液，从而引发了严重的代谢性酸中毒。通过标准的单程血液透析，酸中毒得到缓解。在另外五名患者中，发现使用吸附剂系统的透析液中碳酸氢盐浓度较低且变化很大（均值±标准差，16.5±8.3 mEq/L，范围为5 mEq/L至39 mEq/L）。透析液中低碳酸氢盐未能纠正代谢性酸中毒，实际上，还能够进一步降低血清碳酸氢盐。再生 cartridge 释放质子的能力使得这种透析形式成为代谢性酸中毒的一个潜在原因。吸附剂系统透析的安全性，至少在碳酸氢盐模式下，需要进一步评估。
