Lactate or bicarbonate in dialysis fluid for daily home hemodialysis: advantages and disadvantages

Authors

DOI:

https://doi.org/10.25796/bdd.v6i2.78643

Keywords:

daily hemodialysis, low dialysate flow rate

Abstract

The availability since the beginning of the 20th century of hemodialysis monitors similar to the cyclers used for automated peritoneal dialysis (space-saving and easy-to-handle monitors using a low volume of dialysis fluid and suitable for daily dialysis) has led to renewed interest in home hemodialysis. As in peritoneal dialysis, these cyclers use either lactate - an anion whose metabolism leads to bicarbonate regeneration - or bicarbonate in the dialysate. The purpose of this article is to review the advantages and disadvantages of these two types of alkalinizing anion. Whichever type of anion is used, it is important to avoid over-alkalinization of the patient. Lactate dialysate, which is less expensive and easier to handle, seems to be suitable for most patients, but its use in patients with abnormal liver function should be discouraged.

References

Mion CM, Hegstrom RM, Boen ST, Scribner BH.

Substitution of sodium acetate for sodium bicarbonate in the bath fluid for hemodialysis.

Trans Am Soc Artif Intern Organs 1964, 10: 110-113.

Graefe U, Milutinovich J, Follette WC, Vizzo JE, Babb AL, Scribner BH.

Less dialysis-induced morbidity and vascular instability with bicarbonate in dialysate.

Ann Intern Med 1978, 88: 332-336.

Faller B, Marichal JF.

Loss of ultrafiltration in continuous ambulatory peritoneal dialysis : A role for acetate.

Peritoneal Dial Bull 1984, 4: 10-13.

Cherukuri S, Bajo M, Colussi G, Corciulo R, Fessi H, Ficheux M, Slon M, Weinhandl E, Borman N.

Home hemodialysis treatment and outcomes: retrospective analysis of the Knowledge to Improve Home Dialysis Network in Europe (KIHDNEy) cohort.

BMC Nephrol 2018, 19: 262.

Fessi H, Szelag JC, Courivaud C, Nicoud P, Aguilera D, Gilbert O, Morena M, Thomas M, Canaud B, Cristol JP.

Safety and efficacy of short daily hemodialysis with Physidia S3 system : Clinical performance assessment during the training period.

J Clin Med 2023, 12: 1357.

Scheppach W, Kortmann B, Burghardt W, Keller F, Kasper H, Bahner U, Teschner M, Heidland A.

Effects of acetate during regular hemodialysis.

Clin Nephrol 1988, 29: 19-27.

Veech RL.

The untoward effects of the anions of dialysis fluids.

Kidney Int 1988, 34: 587-597.

Bingel M, Lonnemann G, Koch KM, Dinarello CA, Shaldon S.

Enhancement of in-vitro human interleukin-1 production by sodium acetate.

Lancet 1987, ii: 14-16.

Lonnemann G, Bingel M, Koch KM, Shaldon S, Dinarello CA.

Plasma interleukin-1 activity in humans undergoing hemodialysis with regenerated cellulosic membranes.

Lymphokine Res 1987, 6: 63-70.

Hakim RM, Pontzer MA, Tilton D, Lazarus JM, Gottlieb MN.

Effects of acetate and bicarbonate dialysate in stable chronic dialysis patients.

Kidney Int 1985, 28: 535-540.

Fournier G, Potier J, Thebaud HE, Majdalani G, Ton-That H, Man NK.

Substitution of acetic acic for hydrochloric acid in the bicarbonate buffered dialysate.

Artif Organs 1998, 22: 608-613.

Leunissen KM, van den Berg BW, van Hooff JP.

Ionized calcium plays a pivotal role in controlling blood pressure during haemodialysis.

Blood Purif 1989, 7: 233-239.

Hood VL, Tannen RL.

Protection of acid-base balance by pH regulation of acid production.

N Engl J Med 1998, 339: 819-826.

Leunissen KM, Claessens PJ, Mooy JM, van Hooff JP, Shaldon S.

Chronic haemodialysis with bicarbonate dialysate. Technical and clinical aspects.

Blood Purif 1990, 8: 347-358.

Ganss R, Aarseth HP, Nordby G.

Prevention of hemodialysis associated hypoxemia by use of low-concentration bicarbonate dialysate.

ASAIO J 1992, 38: 820-822.

Symreng T, Flanigan MJ, Lim VS.

Ventilatory and metabolic changes during high-efficiency hemodialysis.

Kidney Int 1992, 41: 1064-1069.

Mudge GH, Manning JA, Gilman A.

Sodium acetate as a source of fixed base.

Proc Soc Exp Biol Med 1949, 71: 136-138.

Hartmann AF.

Theory and practice of parenteral fluid administration.

JAMA 1934, 103: 1349-1354.

Dalal S, Yu AW, Gupta DK, Kar PM, Ing TS, Daugirdas JT.

L-Lactate high-efficiency hemodialysis : hemodynamics, blood gas changes, potassium/phosphorus, and symptoms.

Kidney Int 1990, 38: 896-903.

Dalal SP, Ajam M, Gupta DK, Gupta R, Nawab Z, Manahan FJ, Ing TS, Daugirdas JT.

L-Lactate for high-efficiency hemodialysis : feasibility studies and a randomized comparison with acetate and bicarbonate.

Int J Artif Organs 1989, 12: 611-617.

Davenport A, Will EJ, Davison AM.

The effect of lactate-buffered solutions on the acid-base status of patients with renal failure.

Nephrol Dial Transplant 1989, 4: 800-804.

Thomas AN, Guy JM, Kishen R, Geraghty IF, Bowles BJM, Vadgama P.

Comparison of lactate and bicarbonate buffered haemofiltration fluids : use in critically ill patients.

Nephrol Dial Transplant 1997, 12: 1212-1217.

Bollmann MD, Revelly JP, Tappy L, Berger MM, Schaller MD, Cayeux MC, Martinez A, Chioléro RL.

Effect of bicarbonate and lactate buffer on glucose and lactate metabolism during hemodiafiltration in patients with multiple organ failure.

Intensive care Med 2004, 30: 1103-1110.

Kierdorf HP, Leue C, Arns S.

Lactate- or bicarbonate-buffered solutions in continuous extracorporeal renal replacement therapies.

Kidney Int 1999, 56(Suppl 72): S32-S36.

Heering P, Ivens K, Thümer O, Braüse M, Grabensee B.

Acid-base balance and substitution fluid during continuous hemofiltration.

Kidney Int 1999, 56(Suppl 72): S37-S40.

Bommer J, Locatelli F, Satayathum S, Keen ML, Goodkin DA, Saito A, Akiba T, Port FK, Young EW.

Association of predialysis sodium bicarbonate levels with risk of mortality and hospitalization in the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Am J Kidney Dis 2004, 44: 661-671.

Published

2023-07-18

How to Cite

1.
Petitclerc T. Lactate or bicarbonate in dialysis fluid for daily home hemodialysis: advantages and disadvantages. Bull Dial Domic [Internet]. 2023 Jul. 18 [cited 2023 Oct. 2];6(2):51-8. Available from: https://www.bdd.rdplf.org/index.php/bdd/article/view/78643