| Effects of Acetate-Free Citrate-Containing Dialysate on Metabolic Acidosis, Anemia, and Malnutrition in Hemodialysis Patients. | |
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MedLine Citation:
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PMID: 21954915 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Previously, dialysate contained small amounts of acetate as an alkaline buffer. Recently, acetate-free dialysate (A[-]D) has been available. We evaluated the clinical effect of A(-)D over acetate-containing dialysate (A(+)D) on acid-base balance, anemia, and nutritional status in maintenance hemodialysis (MHD) patients. Twenty-nine patients on MHD were treated with A(+)D for 4 months (first A(+)D), switched to A(-)D for 4 months, and returned to A(+)D for the next 4-month period (second A(+)D). Metabolic acidosis: Serum bicarbonate (HCO3(-) ) levels did not change in patients with normal HCO3(-) levels (≥20 mEq/L) throughout the study. Meanwhile, in patients with initially low HCO3(-) levels, it was significantly increased during the A(-)D period only. Anemia: In patients with target hemoglobin (Hb) ≥10 g/dL, Hb levels were maintained during the study period, even if the dose of erythropoiesis-stimulating agents (ESAs) decreased. In patients with low Hb levels, it was significantly increased in the A(-)D period without increasing ESA or iron doses. Nutritional Condition: In patients with normal albumin levels (≥3.8 g/dL), albumin did not change throughout the study period. However, in patients with lower albumin levels, it was significantly increased during the A(-)D period. These improvements in metabolic acidosis, anemia, and nutrition in the A(-)D period completely dissipated during the second A(+)D period. Hemodialysis (HD) with A(-)D may improve a patient's clinical status with intractable metabolic acidosis, hyporesponsiveness to ESA, and malnutrition that were not normalized in HD with A(+)D. |
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Authors:
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Takahiro Kuragano; Aritoshi Kida; Minoru Furuta; Mana Yahiro; Rie Kitamura; Yoshinaga Otaki; Hiroshi Nonoguchi; Akihide Matsumoto; Takeshi Nakanishi |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-29 |
Journal Detail:
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Title: Artificial organs Volume: - ISSN: 1525-1594 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802778 Medline TA: Artif Organs Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc. |
Affiliation:
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Department of Internal Medicine Division of Kidney and Dialysis, Hyogo College of Medicine Seishoukai Aoi Hospital, Nishinomiya, Hyogo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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