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        "resumen" => "Clinical and analytical changes in hemodialysis without acetate Background: the purpose of this study was to evaluate blood acetate levels and its correlation with clinical and analytical changes in hemodialysis patients treated with standard bicarbonate dialysate compared to treatment with acetate-free bicarbonate dialysate. Methods: fourteen patients on hemodialysis (11 male) with mean age of 61 ¿ 15 years, were treated with conventional bicarbonate dialysate for 1 month and then switched to acetate-free bicarbonate dialysate for another month. Blood samples were drawn at the third session of first and fourth week of each type of dialysis. Results: Pre-dialysis blood acetate levels were similar in both groups, whereas post-dialysis blood acetate levels were higher in patients treated with conventional bicarbonate dialysate (0.48 ¿ 0.64 vs. 0.18 ¿ 0.23 mmol/L, p=0.024). Moreover, both periods had similar percentage of patients with pre-dialysis blood acetate levels in the pathologic range, whereas this percentage was higher in post-dialysis samples from patients treated with conventional bicarbonate dialysate respect to acetate-free dialysate (67% vs. 21%, p=0.001). Serum levels of interleukin-6 were statistically higher in the period with conventional bicarbonate dialysate (31.7 ¿ 24.7 vs. 18.7 ¿ 10.3 pg/ml, p=0.014), even though other inflammatory markers such as LBP, TNF-¿ and CRP failed to increase in the same period. We didn¿t found significant differences in the other parameters studied except for the changes in serum concentrations of sodium, chloride and bicarbonate. Conclusions: Acetate-free bicarbonate dialysate does not expose patients to a big amount of acetate and allows that the majority of patients finished hemodialysis with blood acetate levels in the physiologic ranges. Acetate-free dialysate was safe and well tolerated by our hemodialysis patients, although clinical advantages derived from its use should be evaluated in long-term prospective studies. "
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        "resumen" => "Introducción: El objetivo de dicho estudio fue evaluar los cambios en la acetatemia durante la hemodiálisis (HD) en pacientes con líquido de diálisis (LD) convencional con acetato y en pacientes con LD con clorhídrico (HCl) y analizar sus efectos sobre la clínica y sobre distintos parámetros analíticos. Material y métodos: 14 pacientes en programa de HD estable (11 hombres) de 61 ± 15 años de edad fueron dializados durante 1 mes con el LD convencional con acetato y durante el segundo mes con el LD con HCl (sin acetato). Se obtuvieron análisis pre y post-diálisis la tercera sesión de las semanas 1 y 4 en cada uno de los períodos (con y sin acetato). Resultados: Las medias de los acetatos pre-diálisis fueron similares en ambos grupos, mientras que las medias de los acetatos post-diálisis fueron significativamente superiores en el grupo tratado con el LD convencional (0,48 ± 0,64 vs 0,18 ± 0,23 mmol/L, p = 0,024). Tampoco hallamos diferencias significativas entre los 2 grupos en cuanto a la presencia de valores de acetato pre-diálisis patológicos, mientras sí hallamos un mayor porcentaje valores patológicos de acetato post-diálisis en el grupo tratado con LD convencional respecto al grupo del HCl (67% vs 21%, p = 0,001). Los niveles plasmáticos de IL-6 fueron significativamente superiores en el periodo de diálisis con acetato (31,7 ± 24,7 vs 18,7 ± 10,3 pg/ml, p = 0,014), aunque no se acompañaron de un aumento de otros marcadores inflamatorios como la LBP, el TNF-α o la PCR dializante el mismo periodo. No hallamos diferencias estadísticamente significativas en los otros parámetros evaluados excepto en la variación de las concentraciones de sodio, cloro y bicarbonato. Conclusiones: El LD sin acetato no expone a los pacientes a concentraciones elevadas de acetato consiguiendo que la mayoría de pacientes (79%) termine la HD con una acetatemia dentro del rango fisiológico. El uso de LD sin acetato es seguro y bien tolerado por los pacientes en hemodiálisis, aunque su traducción clínica debe ser evaluada en estudios prospectivos a más largo plazo."
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Clinical and analytical changes in hemodialysis without acetate
Cambios clínicos y analíticos al sustituir el líquido de diálisis convencional por uno sin acetato
Elisabet Coll, Rafael Pérez-García, Patrocinio Rodríguez-Benítez, Mayra Ortega, Patricia Martínez Miguel, Rosa Jofre, Juan Manuel López-Gó
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        "resumen" => "Clinical and analytical changes in hemodialysis without acetate Background: the purpose of this study was to evaluate blood acetate levels and its correlation with clinical and analytical changes in hemodialysis patients treated with standard bicarbonate dialysate compared to treatment with acetate-free bicarbonate dialysate. Methods: fourteen patients on hemodialysis (11 male) with mean age of 61 ¿ 15 years, were treated with conventional bicarbonate dialysate for 1 month and then switched to acetate-free bicarbonate dialysate for another month. Blood samples were drawn at the third session of first and fourth week of each type of dialysis. Results: Pre-dialysis blood acetate levels were similar in both groups, whereas post-dialysis blood acetate levels were higher in patients treated with conventional bicarbonate dialysate (0.48 ¿ 0.64 vs. 0.18 ¿ 0.23 mmol/L, p=0.024). Moreover, both periods had similar percentage of patients with pre-dialysis blood acetate levels in the pathologic range, whereas this percentage was higher in post-dialysis samples from patients treated with conventional bicarbonate dialysate respect to acetate-free dialysate (67% vs. 21%, p=0.001). Serum levels of interleukin-6 were statistically higher in the period with conventional bicarbonate dialysate (31.7 ¿ 24.7 vs. 18.7 ¿ 10.3 pg/ml, p=0.014), even though other inflammatory markers such as LBP, TNF-¿ and CRP failed to increase in the same period. We didn¿t found significant differences in the other parameters studied except for the changes in serum concentrations of sodium, chloride and bicarbonate. Conclusions: Acetate-free bicarbonate dialysate does not expose patients to a big amount of acetate and allows that the majority of patients finished hemodialysis with blood acetate levels in the physiologic ranges. Acetate-free dialysate was safe and well tolerated by our hemodialysis patients, although clinical advantages derived from its use should be evaluated in long-term prospective studies. "
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        "resumen" => "Introducción: El objetivo de dicho estudio fue evaluar los cambios en la acetatemia durante la hemodiálisis (HD) en pacientes con líquido de diálisis (LD) convencional con acetato y en pacientes con LD con clorhídrico (HCl) y analizar sus efectos sobre la clínica y sobre distintos parámetros analíticos. Material y métodos: 14 pacientes en programa de HD estable (11 hombres) de 61 ± 15 años de edad fueron dializados durante 1 mes con el LD convencional con acetato y durante el segundo mes con el LD con HCl (sin acetato). Se obtuvieron análisis pre y post-diálisis la tercera sesión de las semanas 1 y 4 en cada uno de los períodos (con y sin acetato). Resultados: Las medias de los acetatos pre-diálisis fueron similares en ambos grupos, mientras que las medias de los acetatos post-diálisis fueron significativamente superiores en el grupo tratado con el LD convencional (0,48 ± 0,64 vs 0,18 ± 0,23 mmol/L, p = 0,024). Tampoco hallamos diferencias significativas entre los 2 grupos en cuanto a la presencia de valores de acetato pre-diálisis patológicos, mientras sí hallamos un mayor porcentaje valores patológicos de acetato post-diálisis en el grupo tratado con LD convencional respecto al grupo del HCl (67% vs 21%, p = 0,001). Los niveles plasmáticos de IL-6 fueron significativamente superiores en el periodo de diálisis con acetato (31,7 ± 24,7 vs 18,7 ± 10,3 pg/ml, p = 0,014), aunque no se acompañaron de un aumento de otros marcadores inflamatorios como la LBP, el TNF-α o la PCR dializante el mismo periodo. No hallamos diferencias estadísticamente significativas en los otros parámetros evaluados excepto en la variación de las concentraciones de sodio, cloro y bicarbonato. Conclusiones: El LD sin acetato no expone a los pacientes a concentraciones elevadas de acetato consiguiendo que la mayoría de pacientes (79%) termine la HD con una acetatemia dentro del rango fisiológico. El uso de LD sin acetato es seguro y bien tolerado por los pacientes en hemodiálisis, aunque su traducción clínica debe ser evaluada en estudios prospectivos a más largo plazo."
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Article information
ISSN: 20132514
Original language: English
DOI:
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Nefrología (English Edition)