Indications
Glacial Acetic Acid is concentrated, almost water-free acetic acid (the acid found in vinegar, but far stronger). In medicine it is mainly used as a component of the acid concentrate for haemodialysis, the treatment that cleans the blood of people with kidney failure. In the dialysis machine, the acid concentrate is mixed with a bicarbonate concentrate and purified water to make the final dialysis fluid. It is not a medicine to be swallowed or applied by patients.
How It Works
In bicarbonate dialysis, a small amount of acetic acid in the acid concentrate keeps the final dialysis fluid at the right acidity (pH). This stops calcium and magnesium from forming solid deposits with bicarbonate. The small amount of acetate that passes into the blood during dialysis is changed by the liver and muscles into bicarbonate, which helps correct the acid build-up seen in kidney failure.
Dosage and Administration
Used only in dialysis units by trained staff. The concentrate is diluted automatically by the dialysis machine in a fixed ratio set by the manufacturer and the kidney specialist. The dialysis prescription (time, flow rates and fluid composition) is decided by the doctor. Never use concentrate undiluted, and never inject or drink it.
Interactions
As part of dialysis fluid it does not have important direct drug interactions. Dialysis itself can remove some medicines from the blood, so the kidney team may time or adjust doses of other medicines around dialysis sessions.
Contraindications
- Must not be used undiluted, injected or taken by mouth.
- Acetate-containing dialysis fluid may be avoided in people known to react badly to acetate; the doctor will choose a suitable fluid.
Side Effects
When correctly diluted, problems are uncommon. Some people may feel headache, nausea, low blood pressure, muscle cramps or tiredness during or after dialysis; these are usually linked to the dialysis process as a whole. Concentrated acetic acid is corrosive: it can burn the skin and eyes and its fumes irritate the nose, throat and lungs.
Get urgent medical help, or tell the dialysis staff at once, if you have chest pain, breathing difficulty, severe dizziness or fainting, confusion, or a severe headache during dialysis. If concentrated acid touches the skin or eyes, rinse with plenty of water for at least 15 minutes and seek medical care; if swallowed, do not make the person vomit and get emergency help.
Pregnancy and Lactation
Women who are pregnant or breastfeeding and need dialysis can be treated with standard dialysis fluids; the kidney specialist will plan and monitor treatment closely.
Precautions and Warnings
Handle the concentrate with gloves and eye protection in a ventilated area. Check that the correct concentrate is connected to the machine and that the machine’s conductivity alarms are working, because a wrong mix can cause serious harm. Keep containers closed. Glacial acetic acid can freeze at about 16°C and is flammable.
Overdose
A wrongly mixed dialysis fluid can upset the body’s salts and acid balance, causing symptoms such as low blood pressure, confusion or abnormal heart rhythm. Dialysis should be stopped and the patient assessed by the medical team at once.
Therapeutic Class
Haemodialysis solution component (acidifying agent).
Storage
Store as directed on the pack, in a cool, well-ventilated place away from heat and flames, with containers tightly closed and out of the reach of children. Hospital or dialysis-unit use only.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.