A mechanism of hypoxemia during hemodialysis. Consumption of CO2 in metabolism of acetate

American Journal of Nephrology
M S OhH J Carroll

Abstract

The present study is an investigation of the role of acetate metabolism in dialysis-induced hypoxemia and of the relative roles of acetate metabolism, bicarbonate loss, and CO2 gas (g) loss in causation of hypoxemia. The loss of CO2 (g) measured in 23 patients during acetate dialysis was found to be negligible (0.21 +/- 0.01 mmol/min). The HCO-3 loss was substantial (3.4 +/- 0.5 mmol/min), but its predicted effect on dialysis hypoxemia was modest. The infusion of acetate at 4 mmol/min into 6 normal volunteers decreased the respiratory exchange ratio (R) from 0.83 +/- 0.06 to 0.71 +/- 0.06 with constant O2 consumption (VO2) and reduced net CO2 production (VCO2). In another experiment, the infusion of sodium acetate into 9 normal volunteers resulted in a similar reduction in R (from 0.82 +/- 0.04 to 0.71 +/- 0.04) and arterial pO2 (from 92.3 +/- 1.1 to 78.3 +/- 1.7 mm Hg). The results indicate that acetate metabolism can lead to reduction in R and hypoxemia and suggest that the same mechanism is responsible for hypoxemia during hemodialysis using acetate dialysate.

Citations

Jan 1, 1992·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·J U Leititis, M Brandis
Apr 1, 1988·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M CardosoL Lapierre
Apr 1, 1992·Kidney International·T SymrengV S Lim
Jan 1, 1990·Respiratory Medicine·A Davenport, A J Williams
Apr 3, 2019·Seminars in Dialysis·Jaime Uribarri, Man S Oh

Related Concepts

Acetic Acids
Anoxemia
Carbonic Acid Ions
Carbon Dioxide
Hemodialysis
Dioxygen
Pulmonary Gas Exchange
Vinegar

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