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| 물처리와 혈액투석액 |
| 박성광 , 강성귀 |
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| Abstract |
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Water quality is an important factor in hemodialysis because the dialysis' fluid to which the patient is exposed during treatment is primarily made of water. High concentration of aluminum, calcium, magnesium, chlor- amines, metals and pyrogens may result in serious problems in short-term and long-term dialysis. Water treatment is a process to remove any dissolved organics, inorganics, bacteria and pyrogens that could diffuse into the blood stream from tap water used to prepare dialysate. They mainly consist of softening, deionization, reverse osmosis, and filtration. The choice of the method depends on the quality of the tap water, cost and space. Acetate has long been used as an important constitu- ent of the dialysate to correct the metabolic acidosis and to replenish bicarbonate loss during hemodialysis. But recently bicarbonate is being substituted for acetate because it has fewer dialysis related symptoms, better hemodynamic stability and task performance with more ultrafiltration. So bicarbonate dialysis is recommended for acutely ill patients, seriously ill patients, and those with unstable hemodynamic status. |
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