Hekmat R, Mojahedi M J, Garevani H,
Volume 65, Issue 13 (3-2008)
Abstract
Background: The effect of kind of dialysis solution on the control of blood pressure and
adequacy and efficacy of hemodialysis is a most debated and controversial issue.
Methods: Twenty six chronic hemodialized patients in Ghaem hemodialysis center,
Mashhad, Iran, in winter of the year 2004, enrolled this study for one month. The patients
were dialyzed with bicarbonate buffer and were dialyzed in the next month with acetate.
The kind of membranes and the dialysis machines were the same in both months.
Systolic and diastolic pressures were measured before and after hemodialysis in at least
three hemodialysis sessions, and he means recorded. The mean of the body weight were
also recorded. In the same sessions of hemodialysis by measuring the urea, before and
after hemodialysis, urea reduction ratio (URR), was also calculated. Statistical analysis
was done with paired student t test for paired measurement, and independent t test for
evaluating the effect of the kind of dialysate buffer on the measured parameters.
Results: There were no significant statistical differences between acetate and bicarbonate
dialysis solution buffers in the control of diastolic blood pressure. But use of acetate
buffer resulted in more significant systolic blood pressure reduction compared with
bicarbonate buffer (p=0.045). When adequacy of hemodialysis were compared between
two kinds of buffers there were no significant statistical differences between them. When
the effect of dialysate sodium concentration in the range utilized in two buffers, was
evaluated on the systolic and diastolic pressure reduction, no significant differences,
between two types of buffers attributable to the difference between dialysates sodium
concentrations were found.
Conclusion: Hemodialysis with both, acetate and bicarbonate buffers results in
significant reductions in systolic and diastolic blood pressure, weight and urea ratio. Use
of acetate buffer is more significantly associated with systolic blood pressure reduction
compared to bicarbonate buffer (p=0.045), this effect is independent of the dialysate
buffer sodium concentration.
