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Correction of Postoperative Metabolic Alkalosis and Renal Failure by Hemodialysis

RICHARD D. SWARTZ, M.D.; JAMES E. RUBIN, M.D.; ROBERT S. BROWN, M.D., F.A.C.P.; HENRY M. YAGER, M.D.; THEODORE I. STEINMAN, M.D., F.A.C.P.; and HOWARD S. FRAZIER, M.D.
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▸Reprint requests should be addressed to Richard D. Swartz, M.D.; Beth Israel Hospital; 330 Brookline Avenue; Boston, MA 02215.


Boston, Massachusetts


Ann Intern Med. 1977;86(1):52-55. doi:10.7326/0003-4819-86-1-52
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Three postoperative patients with oliguric renal failure and hypochloremic metabolic alkalosis were treated with hemodialysis using a specially prepared high-chloride, low-acetate dialysate. This mode of therapy corrected the metabolic abnormalities and was significantly more effective than treatment with commercially available high-acetate dialysate at increasing the serum chloride and hydrogen ion concentration and decreasing the serum bicarbonate concentration. Furthermore, hemodialysis with high-chloride, low-acetate dialysate corrected the clinical sequelae of hypoventilation, cardiac arrhythmia, and neuromuscular irritability associated with metabolic alkalosis while treating uremia simultaneously.

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