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Nephrol Dial Transplant (1989) 4: 1060-1064
© 1989 European Renal Association-European Dialysis and Transplant Association

research-article

The Effect of Acetate on Ventilation in Haemodialysis Patients

R. M. Heyrman1, W. A. De Backer1, J. P. Van Waeleghem2 and M. E. De Broe2,

1Departments of Pulmonary Medicine, University Hospital Antwerp Antwerp, Belgium 2Departments of Nephrology-Hypertension, University Hospital Antwerp Antwerp, Belgium

Correspondence and offprint requests to: Correspondence and offprint requests to: Marc E. De Broe, MD, PhD, University of Antwerp, Department of Nephrology-Hypertension, p/a University Hospital Antwerp, Wilrijkstraat 10, B-2520 Edegem/Antwerpen, Belgium

This study evaluates the direct effect of acetate upon ventilation during acetate-haemodialysis. Eight patients with end-stage renal failure who were receiving chronic haemodialysis treatment underwent acetate infusion for 1 h on a day outside a haemodialysis session. Ventilation was continuously measured using respiratory inductance plethysmography, starting 20min before the infusion. Arterial blood samples were drawn and expired gases were analysed at regular intervals. After 1 h of acetate infusion, arterial pH increased rapidly and significantly from 7.38±0.01 to 7.49±0.01, the Vco2 and Vo2 slightly decreased and increased respectively, resulting in a reduced respiratory exchange ratio from 0.81±0.04 to 0.69±0.05. Ventilation slightly decreased only after 60 min, whereas the breathing pattern remained normal; neither apnoea periods nor periodic breathing were observed.

We conclude that the hypoventilation and irregular breathing encountered in acetate-cuprophane haemodialysis is related to CO2/HCO3– unloading and the occurrence of complement-activation-induced hypoxaemia rather than to the small changes in Vco2, Vo2 during metabolism of acetate.

Keywords: Acetate infusion; Gas exchange; Haemodialysis; Respiratory exchange ratio; Ventilation


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