Cardiovascular response to hemodialysis: The effects of uremia and dialysate buffer

Cardiovascular response to hemodialysis: The effects of uremia and dialysate buffer . Cardiovascular instability continues to be one of the primary clinical problems in hemodialysis. Acetate buffer in dialysate is one of the factors that may induce hypotension. Since uremia may have a direct effect on the regulation of the cardiovascular system, the present study was designed to investigate the separate effects of uremia and acetate hemodialysis on blood pressure in anesthesized dogs, as well as the hemodynamic parameters determined by invasive cardiovascular monitoring. Animals were separated into four groups: ( 1 ) group I, hemodialysis with acetate in controls; ( 2 ) group II, hemodialysis with acetate in uremic dogs; ( 3 ) group III, hemodialysis with bicarbonate in controls; and ( 4 ) group IV, hemodialysis with bicarbonate in uremic dogs. Acute uremia was induced by bilateral ureteral ligation and a 90-minute hemodialysis (acetate or bicarbonate) procedure was performed 72 hours later. The results obtained in this study show that, compared with dogs with normal renal function, acute uremia resulted in an elevation in mean arterial pressure (MAP; 178 ± 13 vs. 115 ± 23mm Hg, P