Leblanc M, Moreno L, Robinson O, Tapolyai M, Paganini EP
Bicarbonate dialysate for continuous renal replacement
therapy
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:497 1995
Standard bicarbonate dialysate used for chronic intermittent HD
was sterilized by passage through a high-flux hemofilter and used
for dialysate in CRRT. Metabolic control in 50 ICU patients was
comparable to that in 13 patients who received standard Baxter Dianeal
1.5% solution (lactate base) with improved serum
bicarbonate, reduced anion gap and higher PC02.
Comment: This is an
interesting advance in the field, which suggests that bicarbonate
dialysate containing calcium is stable for 72 hours and potentially may be
beneficial. It is difficult to assess whether the
improvement was uniform in all patients. Subgroup analysis based
on underlying pathophysiology and abnormalities would be useful.
Additionally the logistics and costs of preparing the solution
would need to be explored.
(Mehta)
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Am Soc Nephrol
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