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.

References 

  1. Deodato F, Boenzi S, Santorelli FM, Dionisi-Vici C. Methylmalonic and propionic aciduria. Am J Med Genet Part C Semin Med Genet. 2006;142C:104–112
  2. Matsui SM, Mahoney MJ, Resenberg LE. The natural history of the inherited methylmalonic acidemias. N Engl J Med. 1983;308:857–861
  3. Baumgarter ER, Viardot C. Long-term follow-up of 77 patients with isolated methylmalonic acidemia. J Inherit Metab Dis. 1995;18:138–142
  4. van der Meer SB, Poggi F, Spada M, et al. Clinical outcome of long-term management of patients with vitamin B12 unresponsive methylmalonic acidemia. J Pediatr. 1994;125:903–908
  5. D'Angio CT, Dillon MJ, Leonard JV. Renal tubular dysfunction in methylmalonic acidemia. Eur J Pediatr. 1991;150:259–263
  6. Ohura T, Kikuchi M, Abukawa D, et al. Type 4 renal tubular acidosis (subtype 2) in a patient with methylmalonic acidemia. Eur J Pediatr. 1990;150:115–118
  7. Molteni KH, Oberley TD, Wolff JA, Friedman AL. Progressive renal insufficiency in methylmalonic acidemia. Pediatr Nephrol. 1991;5:323–326
  8. Moreno-Vega A, Govantes JM. Methylmalonic acidemia treated by continuous peritoneal dialysis. N Engl J Med. 1985;312:1641–1642
  9. Van Calcar SC, Harding CO, Lyne P, et al. Renal transplantation in a patient with methylmalonic acidemia. J Inherit Metab Dis. 1998;21:729–737
  10. Van't Hoff WG, Dixon M, Taylor J, et al. Combined liver kidney transplantation in methylmalonic acidemia. J Pediatr. 1998;132:1043–1044
  11. Horster F, Hoffmann GF. Pathophysiology, diagnosis and treatment of methylmalonic aciduria—Recent advances and new challenges. Pediatr Nephrol. 2004;19:1071–1074
  12. Suokas A, Kupari M, Heikkila J, Lindros K, Ylikahri R. Acute cardiovascular and metabolic effects of acetate in men. Alcohol Clin Exp Res. 1998;12:52–58
  13. Bingel M, Lonnemann G, Koch KM, Dinarello CA, Shaldon S. Enhancement of in vitro human interleukin-1 production by sodium acetate. Lancet. 1987;1(8523):14–16
  14. Graefe U, Milutinovich J, Folette 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
  15. Ahmad S, Callan R, Cole JJ, Blagg CR. Dialysate made from dry chemicals using citric acid increases dialysis dose. Am J Kidney Dis. 2000;35:493–499
  16. Charloux A, Lonsdorfer-Wolf E, Richard R, et al. A new impedance cardiograph device for the non-invasive evaluation of cardiac output at rest and during exercise: Comparison with the “direct” Fick method. Eur J Appl Physiol. 2000;82:313–320
  17. Japanese Society of Nephrology. Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease 2009. Tokyo, Japan: Tokyo-Igakusha; 2009;
  18. Santoro A, Ferrari G, Spongano M, Badiali F, Zucchelli P. Acetate-free biofiltration: A viable alternative to bicarbonate dialysis. Artif Organs. 1989;13:476–479
  19. Nishiyama T, Uezu Y, Okuyama H, Kobayashi T, Akisawa T, Koshikawa S. Comparative clinical trial among acetate free biofiltration, biofiltration and bicarbonate hemodialysis. Jpn J Artif Organs. 1993;22:39–42
  20. Amore A, Cirina P, Motola S, et al. Acetate intolerance is mediated by enhanced synthesis of nitric oxide by endothelial cells. J Am Soc Nephrol. 1997;8:1431–1436
  21. Noris M, Todeschini M, Casiraghi F, et al. Effect of acetate, bicarbonate dialysis, and acetate-free biofiltration on nitric oxide synthesis: Implications for dialysis hypotension. Am J Kidney Dis. 1998;32:115–124
  22. Coll E, Perez GR, Rodriguez-Benitez P, et al. Clinical and analytic changes in conventional hemodialysis without acetate. Nefrologia. 2007;27:742–748

 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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