Henrich W L, Woodard T D, Meyer B D, Chappell T R, Rubin L J
Kidney Int. 1983 Aug;24(2):240-5. doi: 10.1038/ki.1983.150.
The superiority of bicarbonate dialysis (Bi HD) over acetate dialysis (Ac HD) using a high sodium dialysate has not been established to our knowledge. We compared to Bi HD to Ac HD over 6 weeks each in ten stable patients using a double-blind crossover design and a dialysate sodium concentration of 140 mEq/liter. The dialyzer, delivery system, and disalysate constituents were identical except for the substitution of Bi or Ac. Interdialytic weight gain, pre- and post-HD blood pressures, and heart rates were also comparable in the two protocols. Beginning of the week pre-HD serum Bi was greater during Bi HD than Ac HD (19.1 +/- 0.9 vs. 15.1 +/- 0.8 mEq/liter, P less than 0.001); post-HD Bi values were also higher during Bi HD. Similarly, pre-HD pH was also greater with Bi HD 7.40 +/- 0.012 vs. 7.35 +/- 0.001 U, P less than 0.01). The number of adverse symptoms and signs were similar during each protocol (2.0 +/- 0.65 for Bi HD vs. 2.5 +/- 0.5 for Ac HD episodes/patient/6 weeks, NS). However, fewer therapeutic interventions were required during the Bi HD protocol (1.5 +/- 0.43 vs. 3.1 +/- 0.6 treatments/patient/6 weeks, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
据我们所知，使用高钠透析液时，碳酸氢盐透析（Bi HD）相对于醋酸盐透析（Ac HD）的优势尚未确立。我们采用双盲交叉设计，透析液钠浓度为140 mEq/升，对10例稳定患者分别进行了为期6周的Bi HD和Ac HD比较。除了Bi或Ac的替换外，透析器、输送系统和透析液成分均相同。两种方案中的透析间期体重增加、透析前和透析后的血压及心率也具有可比性。在Bi HD期间，透析前血清碳酸氢盐（Bi）在每周开始时高于Ac HD（19.1±0.9 vs. 15.1±0.8 mEq/升，P<0.001）；Bi HD期间透析后Bi值也更高。同样，Bi HD时透析前pH值也更高，分别为7.40±0.012 vs. 7.35±0.001，P<0.01）。每个方案期间不良症状和体征的数量相似（Bi HD为2.0±0.65，Ac HD为2.
