EFFECT OF HEMODIALYSIS ON THE HYPERSULFATEMIA OF CHRONIC-RENAL-FAILURE

Concentrations of sulfate can increase eightfold in the blood of patie nts with severe reductions in glomerular filtration rate. Sulfate ente rs the body almost exclusively as the amino acids cysteine and methion ine, and leaves in the urine predominantly as inorganic sulfate. Conce ntrations in plasma may exceed 2.5 mol/L in renal failure, and raise t he anion gap by 5 mEq/L. In studies by the author and colleagues, hemo dialysis using large dialyzers and brisk blood flow rates effectively lowered the concentrations of sulfate in plasma to normal in the immed iate post dialysis period; the sulfate reduction ratio actually exceed ed the urea reduction ratio. Significant correlation was observed betw een the two ratios. Concentrations of sulfate, in conjunction with oth er data, may prove useful for estimating dietary intake of protein and monitoring control of acid-base balance.