American Journal of Kidney Diseases
Volume 54, Issue 4 , Pages 764-769 , October 2009

Metabolic and Hemodynamic Advantages of an Acetate-Free Citrate Dialysate in a Uremic Case of Congenital Methylmalonic Acidemia

  • Takako Saito, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
    • Corresponding Author InformationAddress correspondence to Takako Saito, MD, Department of Nephrology, Jichi Medical University, 3311-1 Yakushiji, Simotsuke, Tochigi, 329-0498 Japan
    • ,
  • Osamu Saito, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Takao Maeda, MCE

      Affiliations

    • Department of Clinical Engineering, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Chiharu Ito, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Yasuhiro Ando, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Takanori Yamagata, MD

      Affiliations

    • Department of Pediatrics, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Shigeaki Muto, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Mariko Momoi, MD

      Affiliations

    • Department of Pediatrics, Jichi Medical University, Shimotuke, Tochigi, Japan
    • ,
  • Eiji Kusano, MD

      Affiliations

    • Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan

Received 6 November 2008 ,Accepted 28 April 2009.

  • Image Result

    Changes in hemodynamic parameters during hemodialysis (HD) with acetate-containing bicarbonate dialysate or acetate-free citrate dialysate. With acetate dialysate, blood pressure (BP) decreased sudden

    Changes in hemodynamic parameters during hemodialysis (HD) with acetate-containing bicarbonate dialysate or acetate-free citrate dialysate. With acetate dialysate, blood pressure (BP) decreased suddenly at 2 hours into the dialysis session (arrow), and heart rate failed to increase to compensate for hypotension. The volume of cardiac output did not change and systemic vascular resistance was not increased at this time. With citrate dialysate, BP was maintained and systemic vascular resistance was stable throughout the HD session. Parameters were measured using Physio Flow Lab-1.

 Originally published online as doi: 10.1053/j.ajkd.2009.04.033 on July 6, 2009.

PII: S0272-6386(09)00769-0

doi: 10.1053/j.ajkd.2009.04.033

American Journal of Kidney Diseases
Volume 54, Issue 4 , Pages 764-769 , October 2009

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