The Role of Acetate in Dialysate for Hemodialysis. An Investigation Using Biochemical and Radiospirometic Techniques.

摘要

The major goal has been to develop a sensitive and reproducible assay for plasma acetate. This has been achieved:Plasma is deproteinized,acidified,subjected to low temperature high vacuum vapor transfer,and gas chromatographed on Chromasorb 101coated with 1% carbowax TPA terminated. The assay is sensitive to acetate concentrations less than 0.05mM with a standard deviation of less than 5% of the mean. Preliminary studies with this assay indicated that the normal venous blood concentration is 0.04plus or minus 0.006mM,and the arterial plasma concentration in patients treated with hemodialysis is 0.25plus or minus 0.07mM. Once dialysis was instituted,plasma concentrations rapidly rose and then reached a steady state between 1-5mM;termination produced a rapid fall with a T1/2of less than 10minutes. The rate of acetate dialysance in vitro and in vivo in influenced by blood flow,and is less than the dialysance of urea. Experiments with normal subjects indicate that infused acetate is rapidly metabolized,producing a metabolic alkalosis. Animal studies to determine the influence of acetate on atherosclerosis are in progress.