{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T23:55:41Z","timestamp":1775087741104,"version":"3.50.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T00:00:00Z","timestamp":1590624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Metabolic acidosis is a common problem in haemodialysis patients, but acidosis overcorrection has been associated with higher mortality. There is no clear definition of the optimal serum bicarbonate target or dialysate bicarbonate. This study analysed the impact of reducing dialysate bicarbonate from 35 to 32\u2009mEq\/L on plasma bicarbonate levels in a cohort of patients treated with online haemodiafiltration (OL-HDF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a prospective cohort study with patients in a stable chronic OL-HDF programme for at least 12\u2009months in the Hospital Clinic of Barcelona. We analysed pre- and post-dialysis total carbon dioxide(TCO2) before and after dialysate bicarbonate reduction from 35 to 32\u2009mEq\/L, as well as the number of patients with a pre- and post-dialysis TCO2 within 19\u201325 and \u226429\u2009mEq\/L, respectively, after the bicarbonate modification. Changes in serum sodium, potassium, calcium, phosphorous and parathyroid hormone (PTH) were also assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 84 patients with a 6-month follow-up. At 6\u2009months, pre- and post-dialysis TCO2 significantly decreased (26.78\u2009\u00b1\u20091.26 at baseline to 23.69\u2009\u00b1\u20091.92\u2009mEq\/L and 31.91\u2009\u00b1\u20090.91 to 27.58\u2009\u00b1\u20091.36\u2009mEq\/L, respectively). The number of patients with a pre-dialysis TCO2 &amp;gt;25\u2009mEq\/L was significantly reduced from 80 (90.5%) to 17 (20.2%) and for post-dialysis TCO2 \u2009&amp;gt;29\u2009mEq\/L this number was reduced from 83 (98.8%) to 9 (10.7%). PTH significantly decreased from 226.09 (range 172\u2013296) to 182.50 (125\u2013239) \u2009pg\/mL at 6\u2009months (P\u2009&amp;lt;\u20090.05) and post-dialysis potassium decreased from 3.16\u2009\u00b1\u20090.30 to 2.95\u2009\u00b1\u20090.48\u2009mEq\/L at 6\u2009months (P\u2009&amp;lt;\u20090.05). Sodium, pre-dialysis potassium, calcium and phosphorous did not change significantly.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Reducing dialysate bicarbonate concentration by 3\u2009mEq\/L significantly and safely decreased pre- and post-dialysis TCO2, avoiding acidosis overcorrection and improving secondary hyperparathyroidism control. An individualized bicarbonate prescription (a key factor in the adequate control of acidosis) according to pre-dialysis TCO2 is suggested based on these results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaa058","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T20:12:32Z","timestamp":1584648752000},"page":"1004-1013","source":"Crossref","is-referenced-by-count":18,"title":["Optimization of dialysate bicarbonate in patients treated with online haemodiafiltration"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5940-8962","authenticated-orcid":false,"given":"Enrique","family":"Montagud-Marrahi","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Broseta","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Rodriguez-Espinosa","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodas","family":"Lidia","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn","family":"Hermida-Lama","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Xipell","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Arias-Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nestor","family":"Fontser\u00e9","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manel","family":"Vera","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep Lluis","family":"Bedini","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naira","family":"Rico","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Maduell","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Cl\u00ednic Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,5,28]]},"reference":[{"key":"2021061514021638300_sfaa058-B1","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1093\/ckj\/sfv057","article-title":"Optimizing haemodialysate composition","volume":"8","author":"Locatelli","year":"2015","journal-title":"Clin Kidney J"},{"key":"2021061514021638300_sfaa058-B2","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1681\/ASN.2016070780","article-title":"Bicarbonate balance and prescription in 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