Was asked today if my K machines would go lower on the bicarb settings down to 25.YEs, they do all the way down to 20mEq.We normally run at 140 mEq of Acid Concentrate and 38mEq of bicarbonate. The physician stated that there is a study that lower bicarbonate levels during dialysis is better for the patient as far as bone loss. I assume calcium plays a role related to the bicarbonate levels during and after txmnts...

Please advise if you have had any experience with such and has it worked well?
Thanks!

Ivan,

Ask the physician where we can find the study, I would like to read it because it goes against conventional thinking (my kinda thing).

Dialysis patients are acidotic, which naturally promotes bone loss. We try to normalize the acidosis by using bicarbonate (acetate in the old days) in the dialysate. As much as I like unconventional ways of doing things, I really can't see the logic in leaving the patient acidotic.

Chuck

chuck
do you think this might be referring to HCO3 profiling in order to maximise PO4 removal during HD??

down under,

The original poster hasn't responded so I have no idea what its really about but....

Here is a link to the abstract of a study that was done "Down Under" that essentially says altering the bicarb level has no effect.

http://jasn.asnjournals.org/cgi/content/abstract/6/6/1607

Chuck

thanks for that chuck
we steer clear of it for that reason
have a look at the competency package question for cannulation..can you help out?