LACTATE VERSUS BICARBONATE ONLINE HEMOFILTRATION - A COMPARATIVE-STUDY

In this study, 6 chronic anuric uremic patients underwent lactate hemo filtration (HF) with a substitution fluid, prepared in bags, for 3 mon ths and bicarbonate HF, with continuous on-line preparation of the sub stitution fluid, for 3 months. We determined Na+, Cl-, K+, total calci um (Ca), ionized calcium (Ca2+), phosphate, intact parathormone (I-PTH ), pH, Pco(2), Po-2, and HCO3- in plasma before, during, and after the treatment, as well as Ca, Ca2+, phosphate, and I-PTH in the ultrafilt rate. Moreover, heart rate (HR) and mean arterial pressure (MAP) were continually recorded during the procedure. Furthermore, the patients u nderwent echocardiographic study before and after the session. In comp arison with lactate, bicarbonate HF caused a significant increase in H CO3- and a decrease in K+ plasma concentrations. This was detectable, with lower significance, even 44 h after the end of the treatment. At the end of the long interdialytic period (68 h after the end of the tr eatment), no significant difference was detectable. pH and Pco(2) show ed a significant but transient increase during HF. The other parameter s investigated did not differ significantly between the two methods.