PMID- 7806416
OWN - NLM
STAT- MEDLINE
DCOM- 19950131
LR  - 20171206
IS  - 0391-3988 (Print)
IS  - 0391-3988 (Linking)
VI  - 17
IP  - 6
DP  - 1994 Jun
TI  - Mechanisms of acid-base homeostasis in acetate and bicarbonate dialysis, lactate 
      hemofiltration and hemodiafiltration.
PG  - 315-21
AB  - The different mechanisms of acidosis buffering were investigated in 15 RDT 
      patients dialyzed in cross-over with four depurative techniques: acetate dialysis 
      (AD), bicarbonate dialysis (BD), lactate hemofiltration (LHF) and 
      hemodiafiltration (HDF) with acetate bath and lactate reinfusion fluid. Blood pH, 
      bicarbonate, blood gases, intraerythrocytic pH - on red cell hemolisates - anion 
      gap, L-lactate, pyruvate, adenosinmonophosphate (ADP) and 2-3 Diphosphoglycerate 
      (2-3 DPG) levels were evaluated. During AD the intradialytic buffering is 
      initially achieved by the CO2 fall and later by the acetate metabolism and an 
      important bicarbonate shift from the intra to the extracellular space. A 
      physiological compensation is obtained during BD with bicarbonate administration 
      and a mild ventilatory response to the pCO2 increase. In LHF the massive lactate 
      administration, with plasma levels of 7 mmol/l, strongly alters the Central 
      Nervous System elettroneutrality inducing a hyperventilatory response with a 
      purely pulmonary acidosis buffering. Furthermore the lactate/pyruvate ratio rose 
      as high as 40:1 with ADP increase and cellular energy depletion. In HDF several 
      different mechanisms are associated: the CO2 fixation, the acetate muscular 
      metabolism, the intra-extracellular bicarbonate shift with the pulmonary response 
      driven by lactate Central Nervous System penetration.
FAU - Panichi, V
AU  - Panichi V
AD  - II Medical Clinic Institute, University of Pisa, Italy.
FAU - Parrini, M
AU  - Parrini M
FAU - Bianchi, A M
AU  - Bianchi AM
FAU - Andreini, B
AU  - Andreini B
FAU - Cirami, C
AU  - Cirami C
FAU - Finato, V
AU  - Finato V
FAU - Palla, R
AU  - Palla R
LA  - eng
PT  - Clinical Trial
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
RN  - 0 (Acetates)
RN  - 0 (Bicarbonates)
RN  - 0 (Diphosphoglyceric Acids)
RN  - 0 (Lactates)
RN  - 0 (Pyruvates)
RN  - 138-81-8 (2,3-Diphosphoglycerate)
RN  - 142M471B3J (Carbon Dioxide)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 61D2G4IYVH (Adenosine Diphosphate)
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - 2,3-Diphosphoglycerate
MH  - Acetates/metabolism
MH  - *Acid-Base Equilibrium
MH  - Adenosine Diphosphate/blood
MH  - Analysis of Variance
MH  - Bicarbonates/blood/metabolism
MH  - Blood Gas Analysis
MH  - Carbon Dioxide/blood
MH  - Cross-Over Studies
MH  - Diphosphoglyceric Acids/blood/metabolism
MH  - Female
MH  - *Hemodiafiltration
MH  - *Hemofiltration
MH  - Homeostasis
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Lactates/blood/metabolism
MH  - Lactic Acid
MH  - Male
MH  - Middle Aged
MH  - Oxygen/blood
MH  - Pyruvates/blood
MH  - *Renal Dialysis
MH  - Uremia/metabolism/*therapy
EDAT- 1994/06/01 00:00
MHDA- 1994/06/01 00:01
CRDT- 1994/06/01 00:00
PHST- 1994/06/01 00:00 [pubmed]
PHST- 1994/06/01 00:01 [medline]
PHST- 1994/06/01 00:00 [entrez]
PST - ppublish
SO  - Int J Artif Organs. 1994 Jun;17(6):315-21.