- Conventional acid concentrate typically contains the chloride salts of sodium, calcium, magnesium and potassium, dextrose and an organic acid (gl. Acetic acid).
- The organic acid used in the ‘acid concentrate’ can be in the form of glacial acetic acid or citric acid.
- The acid concentrate may also contain the salt of an organic acid, such as sodium acetate (Eg. SBPL’s acetate type buffer).
- The purpose of the acid is to lower the pH of the dialysate to below 7.3 so that calcium and magnesium do not precipitate out of solution in the form of carbonate salts when bicarbonate is added.
PART I : The acid concentrate (in liquid form) is composed of the following components in each 1000ml:
- NaCl : 165.00g
- KCl: 6.00g
- CaCl2: 8.10g
- MgCl2: 3.70g
- CH3COOH: 9.50g
- H20: Q.S
- And PART II: The bicarb concentrate part containing
- NaHCO3 : 660.0g
- NaCl: 240.0g
Procedure for use:
- Part I supplied in liquid form in white jerry cans of 10 lts.
- Part II supplied in polythene bags of 900 g each (2 packs are supplied with each can)
- The total contents of part II are dissolved in purified water up to 10lts
- The operator manual of the individual dialysis machine should be followed to obtain the final dialysate options based on a compatible concentrate-pair and standard proportioning ratio to give a final solution by mixing 1:1.83:34 parts of part I:part II: purified water.
The final electrolyte concentration obtained is as follows:
- Na+ 136 mmol/l
- K+ 2.20 mmol/l
- Ca2+ 1.50 mmol/l
- Mg2+ 0.50 mmol/l
- CH3COOH– 4.30 mmol/l
- Cl– 103.00 mmol/l
- HCO3– 39.00 mmol/l
This electrolyte concentration stands in the standard range provided by the W.H.O for the said purpose.
The electrolyte concentration can be tailor made as prescribed by the nephrologists depending on the patient needs.