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PubMed2007

Enteric-coated solid dosage forms containing sodium bicarbonate as a drug substance: an exception from the rule?

Sodium bicarbonate (sodium hydrogen carbonate) is used as an oral medication in disorders such as mild metabolic acidosis and chronic kidney disease. The two commercial products on the German market, bicaNorm and Nephrotrans, and also newly developed multiple-unit pellet formulations, have been characterized in these investigations by in-vitro methods like disintegration and dissolution testing. Both marketed products containing sodium bicarbonate are of sufficient pharmaceutical quality according to the European Pharmacopoeia. However, they and the novel pellet preparations showed different drug release at moderately elevated pH values. Early drug release may cause dose dumping in the stomach and adverse drug effects from the developed carbon dioxide. The soft capsule preparation (Nephrotrans) released the smallest amount of sodium bicarbonate at pH 1 and 4.5 of all formulations tested. It appeared that oral dosage formulations of sodium bicarbonate were an exception to the rule: the monolithic soft capsule seemed to be superior to an enteric-coated tablet as well as to multiple-unit pellet formulations from the biopharmaceutical point of view. Our results correspond with individual reports on adverse effects from patients treated with the sodium bicarbonate products.

Capsules↗
PubMed2003

Factors affecting the microclimate pH of the rat jejunum in ringer bicarbonate buffer.

General characteristics of the microclimate layer on the mucosal surface of the rat jejunum incubated in bicarbonate buffers were investigated in vitro using pH sensitive flat membrane microelectrode. Jejunal surface microclimate (JSM) pH changed from 7.30+/-0.03 to 5.83+/-0.04 when the incubation buffer pH decreased from 8.03+/-0.02 to 6.12+/-0.01. Treatment of the mucosal side with mucolytic substances L-cysteine (1% (wt/v)) and 1,4-dithio-DL-threitol (2 mM) significantly (p<0.01) increased JSM pH. Respiratory chain inhibitor, sodium azide (10 mM) also significantly (p<0.05) increased JSM pH. D-Glucose (10 mM) at the mucosal side markedly (p<0.05) decreased JSM pH, which was attenuated by Na(+)/H(+) exchange inhibitor, amiloride (1 mM). Amiloride had no effect on JSM pH when D-glucose was not present at the mucosal side. In contrast to previous observations using bicarbonate free incubation buffers, we have demonstrated that JSM pH is not a constant value, but is dependent on pH of the incubation buffer. Additionally, Na(+)/H(+) exchanger does not contribute to acidic properties of JSM, when there is no D-glucose in the bicarbonate incubation buffer at the mucosal side of the tissue. In conclusion, we suggest that the bicarbonate buffers which are more close to in vivo situation than bicarbonate free buffers should be preferable incubation media when examining JSM.

Amiloride↗
PubMed1994

Haemo-dialysis/-filtration using sodium bicarbonate depresses cardiac function in critically ill patients with acute renal failure.

The effect of sodium bicarbonate haemodialysis or haemofiltration on cardiac function was prospectively studied in 8 patients with acute renal failure. All of the patients exhibited consciousness disturbance and seven patients were on mechanical ventilation. All but one of the patients demonstrated moderate hyperlactataemia and seven patients were receiving vasoactive amine support. Arterial and mixed venous gas analysis and haemodynamic measurements were performed before and after haemodialysis/-filtration treatment. The buffer was changed in a randomised order between bicarbonate and acetate and 11 crossover studies were completed. After treatment with bicarbonate, the cardiac index and stroke index decreased significantly (4.0 +/- 0.3 to 3.4 +/- 0.4 L/ min/m2, p < 0.05 and 39.6 +/- 2.5 to 32.9 +/- 1.8 L/m2, p < 0.05), whereas no significant changes were observed in cardiac index or stroke index after treatment with acetate. Therefore, the post-dialytic percent changes of cardiac index, stroke index and left ventricular stroke work index were significantly decreased after bicarbonate sessions, as compared to after acetate sessions. Haemo-dialysis/-filtration using sodium bicarbonate can depress cardiac function in critically ill patients on mechanical ventilation with disturbed consciousness, and in those who are receiving vasoactive amine support due to uncompromised haemodynamics associated with hyperlactataemia.

Acetates↗
PubMed1987

Adaptive changes of H+ and/or bicarbonate transport in chronic metabolic acidosis: its quantitative evaluation by using isolated perfused kidney.

We have recently improved the technique of the isolated perfused rat kidney by addition of amino acids to the perfusion solution. Utilizing this improved preparation, we examined to what extent chronic acid-base status can alter H+ and/or bicarbonate transport in the whole kidney and the effect of acetazolamide (10(-4) M) on this process. Kidneys from rats that had been drinking tap water (control), 1.5% NH4Cl (acidotic), or 1.5% NaHCO3 (alkalotic) were perfused with a solution of identical pH and PCO2. During the control period, the fractional bicarbonate reabsorption was higher in acidotic rats than in control rats by 1.0% and urine pH was lower than those in control. On the other hand, the two parameters were not different between control and alkalotic rats. Acetazolamide increased urine pH and decreased the fractional bicarbonate reabsorption in all, but these parameters in acidotic and alkalotic rats were not different compared with those in control. We conclude that adaptive changes of H+ and/or bicarbonate transport in chronic metabolic acidosis corresponds to about 1.0% as fractional bicarbonate reabsorption by the isolated perfused kidney and is largely carbonic anhydrase dependent.

Absorption↗
PubMed1990

Comparison of the effects of parathyroid hormone (PTH) and recombinant PTH-related protein on bicarbonate excretion by the isolated perfused rat kidney.

The isolated perfused rat kidney was used to study the effects of amino-terminal fragments of human parathyroid hormone, hPTH(1-34), bovine parathyroid hormone, bPTH(1-84) and of PTH-related proteins, PTHrP(1-34), PTHrP(1-84), PTHrP(1-108) and PTHrP(1-141) on urinary bicarbonate excretion. PTHrP(1-34) (7 nmol/l), bPTH(1-84) (5.5 nmol/l) and hPTH(1-34) (7 nmol/l) had similar effects in increasing bicarbonate excretion with respect to the control. At lower concentrations (0.7 nmol/l) all PTHrP components, but not hPTH(1-34) or bPTH(1-84) increased bicarbonate excretion significantly. Infusions of PTHrP(1-108) and PTHrP(1-141) at 0.7 nmol/l, while associated with a rise in urinary bicarbonate concentration and excretion during the early stages of perfusion, produced a sharp decline in bicarbonate concentration and excretion in the latter part of perfusion. The different peptides produced no significant differences in glomerular filtration rate, fractional excretion of sodium or urine volume. The absence of substantial differences between the effects of hPTH(1-34) and PTHrP(1-34) are as noted in previous studies. The differences between PTHrP(1-108)/PTHrP(1-141) and PTHrP(1-34) demonstrated here are consistent with (1) the clinical manifestations of acidosis in hyperparathyroidism and alkalosis in humoral hypercalcaemia of malignancy, and (2) an independent action of a component of PTHrP beyond amino acids 1-34.

Animals↗
PubMed1993

Normalization of uremic acidosis in hemodialysis patients with a high bicarbonate dialysate.

Uremic acidosis accompanies chronic renal failure in hemodialysis patients because of a retention of nonvolatile acids. Standard bicarbonate (39 mEq/L) and acetate (38 mEq/L) dialysates do not completely correct the acidosis. The acid-base and biochemical effect of a high-bicarbonate (42 mEq/L) dialysate was evaluated in 38 patients during high-efficiency and high-flux dialysis over 12 wk. All patients were dialyzed on standard bicarbonate dialysate before the study and for 8 wk after the study. In order to monitor potential excessive alkalosis, predialysis and postdialysis arterial blood gases were measured in seven patients who initially had a normal predialysis pH. Serum chemistries revealed no significant changes in predialysis BUN, calcium, ionized calcium, or phosphorus during the 12-wk study. There was no change in postdialysis ionized calcium or phosphorus. Predialysis and postdialysis serum total CO2 (STCO2) increased over the 12-wk study (P < 0.0001). By week 12, 75% of the hemodialysis patients had an STCO2 > 23 mEq/L and no patient had an STCO2 > 30 mEq/L predialysis. After the 8-wk washout, all chemistries were no different from prestudy concentrations. Predialysis blood gases in seven patients with normal predialysis HCO3 revealed a significant increase (P < 0.009) in PCO2 and HCO3 over the 12-wk study; predialysis pH and PO2 did not change. There was no significant change in postdialysis blood gases. It was concluded that: (1) a high-bicarbonate dialysate corrects predialysis acidosis in 75% of hemodialysis patients without causing progressive alkalemia, hypoxia, or hypercarbia; and (2) predialysis BUN, calcium, ionized calcium, and phosphorus are unaffected by high-bicarbonate dialysate.

Acidosis↗
PubMed1983

Effect of atropine on pancreatic bicarbonate output and plasma concentrations of immunoreactive secretin in response to intraduodenal stimulants.

In conscious dogs with gastric and pancreatic Thomas fistulas we studied the effect of atropine (50 micrograms kg-1 intravenously) on pancreatic bicarbonate output and plasma concentrations of immunoreactive secretin in response to intraduodenal bolus injections of HCl (0.75 mmol), L-tryptophan (1 mmol), and sodium oleate (1 mmol). The 10-min integrated bicarbonate response to HCl was 1.7 times greater than the response to oleate and 2.8 times greater than that to tryptophan. Atropine significantly (p less than 0.05) depressed the 10-min integrated bicarbonate response to HCl, oleate, and tryptophan by 67%, 79%, and 61%, respectively. HCl and oleate, but not tryptophan, significantly increased plasma secretin concentrations over basal levels. Atropine did not significantly alter basal plasma concentrations of secretin or the 10-min integrated plasma secretin response to HCl and oleate. We conclude that 1) intraduodenal tryptophan stimulates pancreatic bicarbonate secretion by an atropine-sensitive mechanism, release of secretin not being involved, and 2) in the presence of atropine the depressed pancreatic bicarbonate response to HCl and oleate is not due to decreased release of endogenous secretin.

Animals↗
PubMed1983

Role of sodium, bicarbonate, and plasma osmolality in biliary secretion.

To examine the effect of changes in biliary sodium and bicarbonate secretion on bile formation, experiments were performed on fasted, pentobarbital-anesthetized pigs. During continuous intravenous secretin infusion (2.7 CU X kg body wt-1 X h-1) sodium secretion was altered by increasing or reducing plasma sodium concentration. Bicarbonate secretion was altered by varying arterial plasma pH. At increased biliary sodium secretion, bile formation was depressed, but changes in bicarbonate secretion were accompanied by parallel alterations in bile formation. Bile acid secretion was increased during elevated plasma sodium concentration, whereas reduced plasma sodium concentration depressed bile acid secretion. To distinguish between the effect of changes in plasma osmolality and sodium concentration, bile formation was also studied during intravenous sucrose infusion at normal plasma sodium concentration. About 50% of the effect on bile formation of changing plasma sodium concentration is solely caused by the changes in plasma osmolality. During secretin stimulation bile formation is mainly determined by bicarbonate. Changes in plasma osmolality affect bile secretion through alterations in the net osmotic force across the hepatocellular membrane. Sodium has an impact on the bile-acid-dependent fraction, whereas bicarbonate is the mediator of the bile-acid-independent fraction of bile secretion.

Animals↗
PubMed1987

Effects of acetate versus bicarbonate hemodialysis on left ventricular size and function.

To investigate the effects of different types of hemodialysis on hemodynamics, left ventricular size and function, 10 patients with uremia due to chronic renal failure were examined using echocardiography and measurement of systolic time intervals before and after both acetate and bicarbonate hemodialysis. Both caused decreases in left ventricular end diastolic (acetate -3.2 vs. bicarbonate -5.1 mm, p less than 0.01 for both) and end systolic (-3.2 vs. -3.7 mm, p less than 0.01 for both) diameters, and increases in mVCF (+0.24 vs. +0.23 circ/s, p less than 0.005 for both) and fractional shortening (+2.7%, p less than 0.05 vs. +0.9%, NS). In systolic time intervals, the LVETI decreased (-28 vs. -38 ms, p less than 0.001 for both) and the PEP/LVET ratio increased (+0.04, NS vs. 0.09, p less than 0.01). There were no significant differences between the changes in any of the measured parameters caused by acetate or bicarbonate hemodialysis, except in blood bicarbonate concentration (+1.9 vs. +5.4 mmol/l, difference p less than 0.01). Thus hemodialysis with acetate or bicarbonate base causes similar decreases in left ventricular size apparently because of decreased diastolic filling, but in spite of this, there is an increase in left ventricular systolic function, apparently partially due to increased myocardial contractility.

Acetates↗
PubMed1987

Sodium and bicarbonate fluxes in regenerating rabbit corneal endothelium.

Rabbit corneal endothelia were subjected to a cryoinjury (-70 degrees C for 15 sec) and sodium and bicarbonate fluxes were determined at various times after induction of the endothelial destruction. A complete monolayer of cells was present by 4 days that consisted of large cells that underwent division over the next 16 days. Unidirectional sodium fluxes were unaltered by the transformation from large to normal sized hexagonal cells. Unidirectional bicarbonate fluxes showed an increase in Jendostr coupled with a decrease in the net Jstrendo flux. As the cells became smaller these bicarbonate fluxes returned to normal values. The data indicate that the cell margin/cell size ratio is not related to the flux rates, thus the paracellular pathway increase with healing is not related to the passage of either sodium or bicarbonate. Secondly, the data indicate separate effects on both sodium and bicarbonate, suggesting that transendothelial movement of the ions can be separated and that they are not necessarily linked in passage across the endothelium.

Animals↗
PubMed1996

The effect of hypertonic sodium bicarbonate on QRS duration in rats poisoned with chloroquine.

OBJECTIVE: To determine efficacy of hypertonic sodium bicarbonate in narrowing QRS prolongation produced by chloroquine. DESIGN: Randomized, controlled animal experiment using an accepted rat model of sodium channel blockade. METHODS: Hypotension and widening of QRS complexes (lead II) of the ECG were produced in 16 rats by administration of a total of 87 mg/kg chloroquine intravenously over 20 minutes. Eight rats were treated with 6 mL/kg 1 M sodium bicarbonate intravenously over two minutes beginning ten minutes into the chloroquine infusion. Serial measurements of QRS duration and systolic blood pressure were obtained for 30 minutes. RESULTS: QRS intervals narrowed more rapidly in animals receiving sodium bicarbonate (p = .045), although the difference in mean rate of narrowing between groups was modest at only .23 msec/min. Because of large variances, no statistically significant differences could be demonstrated in systolic blood pressure. CONCLUSIONS: Hypertonic sodium bicarbonate partially reversed sodium channel blockade and resultant QRS interval prolongation produced by chloroquine in rats. These data should be interpreted with caution, given the need to extrapolate to humans and the modest effect of sodium bicarbonate on QRS narrowing.

Amebicides↗
PubMed2005

Influence of extruded soybeans with or without bicarbonate on milk performance and fatty acid composition of goat milk.

The effects of extruded soybeans (ESB) included at 0, 10, or 20% of dry matter (DM) of the diet in combination with sodium bicarbonate (0 vs. 1% bicarbonate added to DM) on rumen fermentation characteristics, production parameters, and fatty acid (FA) profiles of milk fat were examined in 30 midlactation goats and 6 rumen-cannulated goats fed high-concentrate diets (30:70 forage-to-concentrate ratio) ad libitum in a 3 x 2 factorial design. Diets were fed as total mixed rations. The trial lasted 13 wk with the final 9 wk as the test period. Milk yield and composition were recorded each week throughout the trial. Individual samples of milk were taken in wk 4, 7, 10, 11, and 13 to determine FA profile of milk fat. Dry matter intake and intake of net energy for lactation were not affected by dietary treatments. Feeding ESB did not modify ruminal pH or volatile fatty acids concentration in the rumen fluid, but it increased the molar proportion of propionate. Feeding ESB increased fat-corrected milk, milk fat content, and fat yield compared with the control diets. There was no change in milk protein content when ESB were fed. Feeding ESB increased the proportions of oleic, linoleic, and linolenic acids in milk fat at the expense of most of the saturated FA. It also increased the n-6 to n-3 FA ratio of milk. The largest changes in milk yield and milk composition were generally obtained with ESB included at 20% of DM. The addition of sodium bicarbonate tended to increase ruminal pH, VFA concentrations in the rumen fluid, and the molar proportions of acetate. The addition of sodium bicarbonate increased milk fat content and fat yield, with no change in milk FA composition. It is concluded that during midlactation, the inclusion of ESB to 20% of DM prevented low milk fat content for goats fed high-concentrate diets, with no decrease in milk protein content. The addition of sodium bicarbonate may enhance the effects of ESB on milk fat content and fat yield.

Animals↗
PubMedDate not supplied

The effect of prolonged tourniquet application on serum bicarbonate.

BACKGROUND: Many clinicians believe that prolonged tourniquet application lowers the serum bicarbonate concentration in samples drawn from that limb, but this effect has never been examined prospectively. OBJECTIVE: To test the effect of prolonged tourniquet application before phlebotomy on serum bicarbonate concentration in healthy adults. METHODS: We drew blood samples from 27 healthy adult volunteers without a tourniquet and again 1, 3, and 5 minutes after applying a blood pressure cuff and inflating it to the mean arterial pressure. RESULTS: The mean bicarbonate concentration was 27.3 +/- 2.26 mmol/L (standard deviation) at baseline, 27.7 +/- 2.39 mmol/L at 1 minute, 27.7 +/- 2.05 mmol/L at 3 minutes, and 27.7 +/- 1.96 mmol/L at 5 minutes. The mean change in bicarbonate concentration from baseline was -0.04 +/- 1.02 mmol/L at 1 minute, 0.44 +/- 1.05 mmol/L at 3 minutes, and 0.44 +/- 1.31 mmol/L at 5 minutes. The mean lactate concentration was 1.1 +/- 0.28 mmol/L at baseline, 1.3 +/- 0.65 mmol/L at 1 minute, 1.2 +/- 0.52 mmol/L at 3 minutes, and 1.2 +/- 0.36 mmol/L at 5 minutes. The mean change in lactate concentration from baseline was 0.15 +/- 0.67 mmol/L at 1 minute, 0.11 +/- 0.11 mmol/L at 3 minutes, and 0.12 +/- 0.37 mmol/L at 5 minutes. CONCLUSIONS: Prolonged tourniquet application before phlebotomy does not lower the serum bicarbonate concentration in healthy adults.

Adult↗
PubMed1978

Less dialysis-induced morbidity and vascular instability with bicarbonate in dialysate.

We devised three protocols to test the postulate that increased morbidity during high-efficiency dialysis with large-surface-area units (LS) might be due in part to the increased flux of bicarbonate out and acetate into the patient inherent is LS dialysis. The first protocol showed that with LS-acetate dialysis there was a marked fall in plasma bicarbonate and Pco2 during the first 3 to 4 h, followed by a rapid rise in bicarbonate above normal and return to control in Pco2. With LS-bicarbonate dialysis, these oscillations were largely eliminated. A second double-blind protocol showed that central nervous system-type symptoms noted during and after LS-acetate dialysis were reduced significantly by switching to LS-bicarbonate dialysis. The third protocol showed that with LS-carbonate the tolerable rate of ultrafiltration could be increased 67% compared with LS-acetate dialysis.

Acetates↗
PubMed2000

Sodium bicarbonate--an alternative to hyaluronidase in ocular anaesthesia for cataract surgery.

PURPOSE: To evaluate and compare the safety, efficacy and cost-effectiveness of 7.5% sodium bicarbonate buffered lidocaine (pH 7.2) with hyaluronidase mixed lidocaine (pH 4.6) for local anaesthesia in cataract surgery. METHODS: This prospective study comprised two parts. Part I: We evaluated the ocular and systematic anaesthetic safety and efficacy of 7.5% sodium bicarbonate buffered lidocaine on 112 consecutive patients undergoing cataract extraction with intraocular lens (IOL) implantation. At 12-week postoperative follow up final visual acuity and detailed fundus examination was done. Part II: It was conducted as a double blind, randomized comparative clinical trial involving 120 patients undergoing cataract surgery under retrobulbar anaesthesia. Patients were randomly assigned to one of the two groups: 60 eyes received 2 ml of 2% lidocaine with 1:200,000 epinephrine and 1 ml of 7.5% sodium bicarbonate, (0.299 mmol/ml); the remaining 60 eyes received 2 ml of 2% lidocaine with 1:200,000 epinephrine and 450 units of hyaluronidase (15 U/ml). In the event of incomplete akinesia, retrobulbar blocks were supplemented at 10 minutes. Onset and duration of anaesthesia and akinesia were assessed and compared in both groups. RESULTS: The pH-adjusted lidocaine group did not show any demonstrable variation in blood pressure (BP) or other systemic reaction. No anaesthesia-related adverse ocular effects were observed either during or after surgery. Thirty-one eyes (51.6%) achieved complete anaesthesia and akinesia within 5 minutes compared to 13 eyes (21.6%) in the hyaluronidase group. However, the overall mean onset time of anaesthesia and akinesia, repeat block rate and the duration of the anaesthesia were comparable in both the groups--p: 0.14). Twelve weeks postoperatively 88.39% of patients showed a best corrected visual acuity of 6/18 or better (73.21%-6/12 or better). CONCLUSION: In this study, sodium bicarbonate buffered 2% lidocaine was found to be a safe and effective local anaesthetic, with reduced time of onset, and improved quality of both anaesthesia and akinesia. Sodium bicarbonate (7.5%) may be used as an alternative to hyaluronidase in ocular anaesthesia. It is readily available and is cost effective.

Adult↗
PubMed1996

The use of sodium bicarbonate in oral hygiene products and practice.

Early dentifrices contained natural ingredients, mostly in coarse particle form, and were quite abrasive. Salts, either sodium chloride, sodium bicarbonate, or a mixture of both, have also been used for tooth cleaning because of their ready availability and low cost. Because of both their relatively low intrinsic hardness and their high solubility, another advantage is low abrasivity. Their biggest disadvantage is a salty, unpalatable taste. Many modern dentifrices that contain sodium bicarbonate, either as the sole abrasive or one of several, disguise the saltiness with flavoring and sweetening agents. An almost inverse relationship exists between the percentage of baking soda in a dentifrice and its abrasivity. Sodium bicarbonate has no anticaries activity per se but is compatible with fluoride. In high concentrations, sodium bicarbonate is bactericidal against most periodontal pathogens. Most clinical studies have not found significant differences in periodontal response to baking soda as compared with other commercial dentifrices, probably because of its rapid clearance from the gingival sulcus. Sodium bicarbonate may not be the "magic bullet" for curing dental diseases, but its safety (if ingested), low abrasivity, low cost, and compatibility with fluoride make it a consummate dentifrice ingredient.

Anti-Infective Agents, Local↗
PubMed2001

Acute versus chronic sodium bicarbonate ingestion and anaerobic work and power output.

BACKGROUND: The aim of this study was to compare and contrast the effects of acute versus chronic sodium bicarbonate ingestion. METHODS PARTICIPANTS: Eight male, (mean+/-SE): age, 20.8+/-0.4 yrs; height, 179.6+/-0.6 cm; body mass, 79.4+/-0.85 kg, Sigma7skf, 48.6+/-4.8 mm, VO2max=55.9+/-0.8 ml x kg(-1) x min(-1)) volunteer subjects, ingested NaHCO3 in either a dose of 0.5 g x kg(-1) body mass acutely or the same dose daily over a period of six days in order to determine whether there were any differences in performance of 90 sec maximal cycling ergometry. INTERVENTION: After subjects undertook an initial control (C) test session, all were then randomly assigned to one of two groups, acute or chronic NaHCO3 ingestion. Subjects in the acute ingestion (AI) group completed their supplemented test on day one, and then on the following day. Chronic ingestion (CI) subjects completed the test after one day of chronic ingestion as well as following six days of bicarbonate ingestion. Following ten days rest, subjects repeated the protocol in the opposite group. MEASURES: Blood samples were taken pre- and postingestion, daily, and pre- and postexercise and were analysed for, pH, Base excess (BE), HCO3-, PO2, PCO2, Na+, K+, Cl-, and lactate. RESULTS: Both the chronic (CI) and acute ingestion (AI) groups were significantly different to the control (C) value (p<0.001 and p<0.05, respectively). CONCLUSIONS: We would suggest using chronic ingestion as a means to improve high intensity work rather than the acute ingestion of sodium bicarbonate. The ingestion of sodium bicarbonate, over a period of six days, significantly improved work output two days after bicarbonate ingestion ceased.

Acid-Base Equilibrium↗
PubMed2001

[Bicarbonate versus acetate hemodialysis: effects on the acid-base status].

BACKGROUND: Metabolic acidosis is an inevitable complication of chronic renal failure and one the major goals of haemodialysis (HD) treatment is correction of acidosis. The main aim of study was to compare effects of bicarbonate versus (vs) acetate HD on acid-base. METHODS: A sample of 36 patients (pts) was done, 20 males and 16 females, aged 52.4 +/- 12.7 years, duration on HD 46.8 +/- 40.2 months, 15 pts on acetate and 21 pts on bicarbonate HD. We determined the parameters of acid-base before and after HD, electrolyte status, Kt/V and URR. RESULTS: At start of HD: pH-7.33 +/- 0.04; pCO2-4.95 +/- 0.5 kPa; HCO3 19.1 +/- 1.9 mmol/L on bicarbonate HD vs. pH-7.33 +/- 0.03; pCO2-4.81 +/- 0.4kPa; HCO3(-)-18.7 +/- 2.0 mmol/L on acetate HD. At the end of session: pH-7.45 +/- 0.02; pCO2-5.07 +/- 0.4 kPa; HCO3(-)-26.3 +/- 1.5 mmol/L on bicarbonate HD vs. pH-7.43 +/- 0.03; pCO2-4.55 +/- 0.3 kPa; HCO3(-)-22.6 +/- 1.8 mmol/L on acetate HD. CONCLUSION: Bicarbonate as a physiological buffer is much efficient in correction of metabolic acidosis and should be preferred in HD treatment.

Acetates↗