Biofiltration with buffer-free dialysate
Buoncristiani, U.; Ragaiolo, M.; Petrucci, V.; Bruni, F.; Pala, E.; Damiani, C.; Brugnano, R.
International Journal of Artificial Organs 9(Suppl 3): 9-14
1986
ISSN/ISBN: 0391-3988 PMID: 3557684 Document Number: 271555
The presence of acetate in the dialysate appears to be superfluous in the new depurative technique indicated as biofiltration, which consists in a standard hemodialysis with high ultrafiltration combined with the reinfusion of 3-4 1/2 liters of solution containing bicarbonate. The presence of acetate could in fact be contraindicated by a number of potential side effects, metabolic, cardiovascular and biological. Hence, starting from the consideration that in standard biofiltration a buffer is already infused directly as bicarbonate, we tried to overcome the potential hazards of the acetate-containing bath simply by using a dialysate without acetate and by increasing the concentration of bicarbonate in the reinfusate. A cumulative clinical experience of 20 months in 4 patients proved the feasibility and safety of the technique and suggests further advantages over standard biofiltration (better control of acid-base equilibrium, better cardiovascular stability.