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Genesis of dialysis solution composition

Publication at First Faculty of Medicine |
2017

Abstract

Despite being perceived as a rather stable part of the artificial kidney, composition of dialysis solution - similarly to the other two component of artificial kidney, dialyzer and dialysis machine - went through a number of changes. In key developmental steps, changes in one of those components implicated or induced changes in the other ones.

Since the initiation of terminal renal failure treatment by dialysis in the 60-ies, roughly nine principal changes can be identified in dialysate composition. Those changes are described and commented in the article: replacement of bicarbonate by acetate, increase in dialysate sodium, return to bicarbonate, introduction of dry bicarbonate concentrate, change-over from the "purity" to "ultrapurity" standard, decrease in glucose content, innovation of acidifying agent, addition of phosphates, inclusion of ferric salt.

Also monitoring of dialysate composition developed from simple conductivity measurement over temperature compensation to current display of sodium and bicarbonate concentrations. Regulatory framework of fluids in dialysis has changed with recent adoption of the pentad of ČSN EN ISO standards, too.