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Nephrol Dial Transplant (1987) 1: 229-232
© 1987 European Renal Association-European Dialysis and Transplant Association

research-article

Cardiovascular and Acid—Base Effects of Acetate and Bicarbonate Haemodialysis

M. A. Mansell1,, S. H. Morgan1, R. Moore2, C. H. Kong1, M. F. Laker3 and A. J. Wing2

1St Peter's Hospitals and Institute of Urology London, UK 2Renal Unit, St Thomas's Hospital London, UK 3Royal Victoria Infirmary Newcastle-upon-Tyne, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr M. A. Mansell, St Philip's Hospital, Sheffield Street, London WC2A 2EX.

Cardiovascular and acid-base changes were studied in 18 adult haemodialysis patients during a single dialysis against acetate or bicarbonate dialysate. Tachycardia was significantly greater with acetate but, otherwise, blood pressure and peripheral resistance fell and cardiac output increased to a similar degree with the two types of dialysate. Arterial PCO2 increased with bicarbonate and fell slightly with acetate, while hypoxaemia was significantly worse during acetate dialysis. Arterial acetate concentrations increased in 2 of 12 patients during bicarbonate dialysis. No differences in patient symptomatology or hypotensive episodes were noted with acetate or bicarbonate. Any beneficial effects of bicarbonate dialysis are more likely to be related to preservation of arterial PO2 than to the absence of adverse cardiovascular effects of acetate.

Keywords: Acetate; Acid–base; Bicarbonate; Circulation; Haemodialysis


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