Indications
The acidic component of bicarbonate haemodialysis solution (often called the A concentrate or acid concentrate) is one of two concentrates used to make dialysis fluid for haemodialysis. Haemodialysis is a treatment for kidney failure in which a machine filters the blood. This concentrate is mixed by the dialysis machine with purified water and the separate bicarbonate component (B concentrate) to produce the final dialysis fluid. It is used only in dialysis units by trained staff and is never injected or swallowed.
How It Works
The acid concentrate contains salts such as Sodium Chloride, Potassium Chloride, Calcium Chloride and Magnesium Chloride, with Glucose in some products, and a small amount of acid such as Acetic Acid or Citric Acid. The acid keeps calcium and magnesium from forming deposits with bicarbonate when the two concentrates are mixed. During dialysis, the blood and the dialysis fluid pass on either side of a thin membrane. Waste products such as urea and excess potassium move from the blood into the fluid, while the fluid salt levels help bring the blood salts and acid balance back towards normal.
Dosage and Administration
The concentrate is connected to the haemodialysis machine, which dilutes and mixes it automatically in a fixed ratio according to the machine settings. The choice of concentrate, the potassium and calcium content, the treatment time and frequency are prescribed by the nephrologist (kidney specialist).
Interactions
The potassium and calcium content of the dialysis fluid affects heart rhythm and can interact with Digoxin; low-potassium fluid in patients taking Digoxin increases the risk of rhythm problems. Medicines removed by dialysis may need dose timing changes; the kidney team manages this.
Contraindications
- Not for injection, infusion or drinking.
- Must not be used on its own without the bicarbonate component and purified water.
- The specific formulation is chosen to suit each patient blood potassium and calcium levels.
Side Effects
Effects during dialysis are mostly related to the procedure and fluid composition: low blood pressure, muscle cramps, nausea, headache, tiredness after dialysis and, if salt levels are not right for the patient, changes in blood potassium or calcium. Rarely, mixing errors can cause serious salt imbalance.
Tell the dialysis staff at once if you feel faint, have chest pain, palpitations, severe cramps, breathlessness, confusion or a severe headache during or after a session.
Pregnancy and Lactation
Pregnant women on dialysis need specialist care, usually with more frequent or longer sessions and adjusted fluid composition. Dialysis can continue during breastfeeding as directed by the kidney team.
Precautions and Warnings
- Check the label to make sure the correct acid concentrate is used for the correct machine and patient.
- Water used must meet dialysis quality standards.
- Blood salt levels are monitored regularly.
- Keep containers closed to avoid contamination.
Overdose
Overdose in the usual sense does not apply. Wrong concentrate or wrong mixing can cause dangerous salt and fluid imbalance; dialysis machines have conductivity alarms, and staff stop and correct the treatment.
Therapeutic Class
Haemodialysis solution concentrate (acid component).
Storage
Store as directed on the pack, usually below 30°C; do not freeze. Keep containers closed and use before the expiry date. Kept in dialysis units, out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.