Phosphate enrichment of dialysate for use in standard and extended haemodialysis

Leonard M Ebah; Mehvosh Akhtar; Ian Wilde; Graeme Hookway; Mark Vincent; Christopher Reeves; John Denton; John Woods; Sandip Mitra

doi:10.1159/000339818

Phosphate enrichment of dialysate for use in standard and extended haemodialysis

Leonard M Ebah, Mehvosh Akhtar, Ian Wilde, Graeme Hookway, Mark Vincent, Christopher Reeves, John Denton, John Woods, Sandip Mitra

Division of Cardiovascular Sciences (L5)

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND/AIMS: Intensive haemodialysis (HD) sometimes causes hypophosphataemia, but phosphate-containing dialysate is not readily available. We examined the effectiveness of extemporaneously producing a phosphate-rich dialysate for use in HD.

METHODS: Incremental volumes of Fleet® were added to acid concentrate and predicted to deliver dialysate phosphate concentrations of 0.19-1.1 mmol/l, following mixture with ultrapure water and base concentrate by the HD machine.

RESULTS: The achieved concentrations were close to predicted values (p = 0.77) and remained stable throughout an 8-hour 'treatment' time (p = 0.99). The dialysate phosphate concentration had a linear relationship with the Fleet® volume added, defined by the regression equation y = 172.79 x - 1.47 (R(2) = 0.99, r = 0.99, p = 0.003). The dialysate pH, calcium, magnesium and bicarbonate concentrations did not change over the study period (p = 0.28-0.99). Microscopic analysis under polarised light showed no evidence of crystal formation.

CONCLUSION: The study validates a simple, reliable and cost-effective protocol for phosphate supplementation in conventional and extended HD.

Original language	English
Pages (from-to)	28-33
Number of pages	6
Journal	Blood Purification
Volume	34
Issue number	1
DOIs	https://doi.org/10.1159/000339818 https://doi.org/10.1159/000339818
Publication status	Published - 2012

Keywords

Calcium
Dialysate
Haemodialysis
Hypophosphataemia
Phosphate

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title = "Phosphate enrichment of dialysate for use in standard and extended haemodialysis",

abstract = "BACKGROUND/AIMS: Intensive haemodialysis (HD) sometimes causes hypophosphataemia, but phosphate-containing dialysate is not readily available. We examined the effectiveness of extemporaneously producing a phosphate-rich dialysate for use in HD.METHODS: Incremental volumes of Fleet{\textregistered} were added to acid concentrate and predicted to deliver dialysate phosphate concentrations of 0.19-1.1 mmol/l, following mixture with ultrapure water and base concentrate by the HD machine.RESULTS: The achieved concentrations were close to predicted values (p = 0.77) and remained stable throughout an 8-hour 'treatment' time (p = 0.99). The dialysate phosphate concentration had a linear relationship with the Fleet{\textregistered} volume added, defined by the regression equation y = 172.79 x - 1.47 (R(2) = 0.99, r = 0.99, p = 0.003). The dialysate pH, calcium, magnesium and bicarbonate concentrations did not change over the study period (p = 0.28-0.99). Microscopic analysis under polarised light showed no evidence of crystal formation.CONCLUSION: The study validates a simple, reliable and cost-effective protocol for phosphate supplementation in conventional and extended HD.",

keywords = "Calcium, Dialysate, Haemodialysis, Hypophosphataemia, Phosphate",

author = "Ebah, {Leonard M} and Mehvosh Akhtar and Ian Wilde and Graeme Hookway and Mark Vincent and Christopher Reeves and John Denton and John Woods and Sandip Mitra",

note = "Copyright {\textcopyright} 2012 S. Karger AG, Basel.",

year = "2012",

doi = "10.1159/000339818",

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journal = "Blood Purification",

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T1 - Phosphate enrichment of dialysate for use in standard and extended haemodialysis

AU - Ebah, Leonard M

AU - Akhtar, Mehvosh

AU - Wilde, Ian

AU - Hookway, Graeme

AU - Vincent, Mark

AU - Reeves, Christopher

AU - Denton, John

AU - Woods, John

AU - Mitra, Sandip

PY - 2012

Y1 - 2012

N2 - BACKGROUND/AIMS: Intensive haemodialysis (HD) sometimes causes hypophosphataemia, but phosphate-containing dialysate is not readily available. We examined the effectiveness of extemporaneously producing a phosphate-rich dialysate for use in HD.METHODS: Incremental volumes of Fleet® were added to acid concentrate and predicted to deliver dialysate phosphate concentrations of 0.19-1.1 mmol/l, following mixture with ultrapure water and base concentrate by the HD machine.RESULTS: The achieved concentrations were close to predicted values (p = 0.77) and remained stable throughout an 8-hour 'treatment' time (p = 0.99). The dialysate phosphate concentration had a linear relationship with the Fleet® volume added, defined by the regression equation y = 172.79 x - 1.47 (R(2) = 0.99, r = 0.99, p = 0.003). The dialysate pH, calcium, magnesium and bicarbonate concentrations did not change over the study period (p = 0.28-0.99). Microscopic analysis under polarised light showed no evidence of crystal formation.CONCLUSION: The study validates a simple, reliable and cost-effective protocol for phosphate supplementation in conventional and extended HD.

AB - BACKGROUND/AIMS: Intensive haemodialysis (HD) sometimes causes hypophosphataemia, but phosphate-containing dialysate is not readily available. We examined the effectiveness of extemporaneously producing a phosphate-rich dialysate for use in HD.METHODS: Incremental volumes of Fleet® were added to acid concentrate and predicted to deliver dialysate phosphate concentrations of 0.19-1.1 mmol/l, following mixture with ultrapure water and base concentrate by the HD machine.RESULTS: The achieved concentrations were close to predicted values (p = 0.77) and remained stable throughout an 8-hour 'treatment' time (p = 0.99). The dialysate phosphate concentration had a linear relationship with the Fleet® volume added, defined by the regression equation y = 172.79 x - 1.47 (R(2) = 0.99, r = 0.99, p = 0.003). The dialysate pH, calcium, magnesium and bicarbonate concentrations did not change over the study period (p = 0.28-0.99). Microscopic analysis under polarised light showed no evidence of crystal formation.CONCLUSION: The study validates a simple, reliable and cost-effective protocol for phosphate supplementation in conventional and extended HD.

KW - Calcium

KW - Dialysate

KW - Haemodialysis

KW - Hypophosphataemia

KW - Phosphate

U2 - 10.1159/000339818

DO - 10.1159/000339818

M3 - Article

C2 - 22889988

SN - 0253-5068

VL - 34

SP - 28

EP - 33

JO - Blood Purification

JF - Blood Purification

IS - 1

ER -

Phosphate enrichment of dialysate for use in standard and extended haemodialysis

Abstract

Keywords

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