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2015 ; 8
(5
): 580-9
Nephropedia Template TP
Locatelli F
; La Milia V
; Violo L
; Del Vecchio L
; Di Filippo S
Clin Kidney J
2015[Oct]; 8
(5
): 580-9
PMID26413285
show ga
Survival and quality of life of dialysis patients are strictly dependent on the
quality of the haemodialysis (HD) treatment. In this respect, dialysate
composition, including water purity, plays a crucial role. A major aim of HD is
to normalize predialysis plasma electrolyte and mineral concentrations, while
minimizing wide swings in the patient's intradialytic plasma concentrations.
Adequate sodium (Na) and water removal is critical for preventing intra- and
interdialytic hypotension and pulmonary edema. Avoiding both hyper- and
hypokalaemia prevents life-threatening cardiac arrhythmias. Optimal calcium (Ca)
and magnesium (Mg) dialysate concentrations may protect the cardiovascular system
and the bones, preventing extraskeletal calcifications, severe secondary
hyperparathyroidism and adynamic bone disease. Adequate bicarbonate concentration
[HCO3 (-)] maintains a stable pH in the body fluids for appropriate protein and
membrane functioning and also protects the bones. An adequate dialysate glucose
concentration prevents severe hyperglycaemia and life-threating hypoglycaemia,
which can lead to severe cardiovascular complications and a worsening of diabetic
comorbidities.
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