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Effect of dialysate potassium and lactate on serum potassium and bicarbonate concentrations during daily hemodialysis at low dialysate flow rates

BMC Nephrology Jul 15, 2019

Leypoldt JK, et al. - In these post-hoc analyses, researchers analyzed patients who transferred from thrice-weekly, in-center hemodialysis (HD) to daily HD at low dialysate flow rates, to determine the associations of dialysate potassium and lactate concentrations on serum levels of potassium and bicarbonate. Following transfer from in-center HD to daily HD, a reduction of predialysis serum potassium by nearly 0.4 mEq/L was observed in relation to dialysate potassium concentration of 1 mEq/L during daily HD; there was no change when dialysate potassium level during daily HD was 2 mEq/L. In relation to dialysate lactate concentration of 40 mEq/L and of 45 mEq/L, a reduction by 1.0 ± 3.3 mEq/L and a rise by 2.5 ± 3.5 mEq/L was noted in the predialysis serum bicarbonate concentration, respectively, following transfer from in-center HD to daily HD. Findings revealed easy achievability of control of serum potassium and bicarbonate concentrations during daily HD at low dialysate flow rates; information regarding the selection of dialysate potassium and lactate concentration can be provided when transfer is from in-center HD to daily HD.
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