A Randomized Controlled Study on the Effects of Acetate-Free Biofiltration on Organic Anions and Acid-Base Balance in Hemodialysis Patients

• Published in: Therapeutic apheresis and dialysis 2015-02, Vol.19 (1), p.63-72
• Main Authors: Sánchez-Canel, Juan J, Hernández-Jaras, Julio, Pons-Prades, Ramón
• Format: Article
• Language: English
• Subjects: Acetate; Acetates; Acid-base balance; Acid-Base Equilibrium - physiology; Acidosis - prevention & control; Age Factors; Aged; Aged, 80 and over; Anions - metabolism; Bicarbonate; Bicarbonates - metabolism; Biofiltration; Cross-Over Studies; Dialysis; Dialysis Solutions - therapeutic use; Female; Hemodiafiltration; Hemodiafiltration - adverse effects; Hemodiafiltration - methods; Humans; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Middle Aged; Reference Values; Renal Dialysis - adverse effects; Renal Dialysis - methods; Risk Assessment; Single-Blind Method; Survival Rate; Treatment Outcome
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/1744-9987.12180

Metabolic acidosis correction is achieved by the transfer of bicarbonate and other buffer anions in dialysis. The aim of this study was to evaluate changes in the main anions of intermediary metabolism on standard hemodiafiltration (HDF) and on acetate‐free biofiltration (AFB). A prospective, in‐center, crossover study was carried out with 22 patients on maintenance dialysis. Patients were randomly assigned to start with 12 successive sessions of standard HDF with bicarbonate (34 mmol/L) and acetate dialysate (3 mmol/L) or 12 successive sessions of AFB without base in the dialysate. Acetate increased significantly during the standard HDF session from 0.078 ± 0.062 mmol/L to 0.156 ± 0.128 mmol/L (P