COMPARATIVE EFFECTS OF ACETATE AND BICARBONATE HEMODIALYSIS ON THE DISTRIBUTION OF WHOLE-BLOOD, PLASMA AND ERYTHROCYTE TOTAL, FREE, SHORT-CHAIN ACYL AND LONG-CHAIN ACYL CARNITINE IN PATIENTS WITH CHRONIC-RENAL-FAILURE

We have investigated the effect of acetate and bicarbonate haemodialys is (HD) on the levels of erythrocyte, whole blood and plasma total (TC ), free (FC), short(SC), long-chain acyl (LC) and acyl (AC) carnitine as well as the ratio of AC to FC in 44 healthy subjects (23 men and 21 women) and 83 patients (42 men and 41 women) with chronic renal failu re (CRF) undergoing regular chronic HD. 42 patients (21 men and 21 wom en) used acetate HD and the remainder (21 men and 20 women) used bicar bonate HD. The mean pre-dialysis erythrocyte, whole-blood and plasma l evels of TC, FC, SC, LC and AC as well as the ratio of AC to FC were n ot significantly different from those in the healthy controls (P < 0.1 ). However, after acetate or bicarbonate HD, erythrocyte, whole-blood and plasma levels of TC, FC, SC: LC and AC declined significantly as c ompared to either pre-dialysis or healthy control levels (P < 0.001). Moreover, after HD, the ratio of AC to FC was significantly higher in patients on acetate HD than either the pre-dialysis figure or that of patients on bicarbonate HD (P < 0.001). The ratio returned to normal w ith bicarbonate HD (P < 0.001). The observed discrepancies in response between acetate and bicarbonate HD may be due to the enhanced formati on of acetyl-CoA and fatty acid synthesis during acetate HD. Med Sci R es 26:367-371 (C) 1998 Lippincott-Raven Publishers.