That earlier choice of acetate as the dialysate buffer is now (very early 80’s) becoming a problem. Oh, it was great when dialysis was slow (12 hours) and had “tight” membranes; but, now, with the more efficient membranes and shorter dialysis, the saw-tooth pattern that existed for toxins is now occurring for our blood buffer. During dialysis, the acetate replaces the bicarbonate buffer; after dialysis, the acetate is slowly converted to bicarbonate. Obviously, this is not the best situation for patients.
Continue reading Bicarbonate Dialysis is better (Dialysis, part 3)