Spanish researchers have found that replacing acetate with citrate in the dialysis bath prevents the formation of vascular calcifications. The advance, published in Scientific Reports, opens a new door to improve the quality of life of hemodialysis patients.
Every year around 43,000 people in Spain undergo dialysis treatment to eliminate toxins that are not expelled naturally due to lack of renal function. This treatment offers a possibility of improving the quality of life, even when there is a risk of vascular calcifications.
Now, researchers from the Jiménez Díaz Foundation, the Autonomous University of Madrid (UAM) and the 12 de Octubre University Hospital have identified that the use of citrate in the dialysis bath could prevent the formation of such calcifications, typically associated with patients on dialysis.
“Citrate, like bicarbonate, is a good pH regulator. It also has the property of capturing calcium and, therefore, preventing the formation of calcifications in the vascular system,” says research director Ricardo Villa-Bellosta.
“During the standard dialysis session with bicarbonate-acetate the blood citrate concentration is reduced by half. On the contrary, the concentration of citrate in plasma increases fivefold when a bicarbonate-citrate bath is used,” adds the researcher.
To carry out the functions that cells perform in the body, they need to feed. But in the same way that the cells feed, they also produce and release their wastes into the blood, which are filtered and disposed of through the urine thanks to the kidney. But when the kidney stops working, these wastes (toxins) cannot be eliminated, resulting in accelerated aging.
The main consequence of the accumulation of these wastes is the reduction of blood pH, which is known as acidosis. To counteract it, during the dialysis session bicarbonate is used, a substance that increases and maintains the blood pH in normal values.
To avoid the formation of calcium and magnesium precipitates in the dialysis fluid, acetate has been used so far, a substance that maintains the pH of the dialysis fluid within the optimum range.
“The replacement of acetate with citrate is a therapeutic alternative, with no added costs and easy application to combat the formation of vascular calcifications,” notes Villa-Bellosta.
“Chronic kidney disease is one of the causes of death that is growing faster in our country. In the not too distant future, it will be part of the group of diseases associated with aging that our increasingly aging society will have to face due to its socio-economic impact,” concludes the researcher.