G-Haemodialysis B

Indications

The bicarbonate component of bicarbonate haemodialysis solution (often called the B concentrate) is one of two concentrates used to make dialysis fluid for haemodialysis, the machine treatment that filters the blood in kidney failure. It is supplied as a concentrated solution or as dry powder (Sodium Bicarbonate, sometimes with Sodium Chloride) that the dialysis machine dissolves and mixes with purified water and the acid component (A concentrate). It is used only in dialysis units by trained staff and is never injected or swallowed.

How It Works

People with kidney failure cannot remove acid from the body properly, so acid builds up in the blood (metabolic acidosis). During haemodialysis, bicarbonate in the dialysis fluid passes across the dialyser membrane into the blood and neutralises the excess acid. This helps protect bones and muscles, improves wellbeing and reduces the risk of high potassium. Bicarbonate is kept separate from the acid component until mixing, so that calcium and magnesium do not form deposits.

Dosage and Administration

The concentrate or cartridge is attached to the dialysis machine, which mixes it automatically. The bicarbonate level of the final dialysis fluid, the treatment time and how often dialysis is done are prescribed by the nephrologist according to blood tests.

Interactions

Changes in blood acid balance during dialysis can affect potassium and calcium levels, which matters for people taking Digoxin or other heart rhythm medicines. The kidney team plans medicine timing around dialysis sessions.

Contraindications

• Not for injection, infusion or drinking.
• Must not be used without the acid component and purified water.
• The bicarbonate level is adjusted carefully in patients with metabolic alkalosis or high blood bicarbonate.

Side Effects

Side effects are mainly related to the dialysis procedure: low blood pressure, muscle cramps, nausea, headache and tiredness. If the bicarbonate level is too high, it can cause alkalosis, with symptoms such as muscle twitching, tingling, light-headedness and, rarely, heart rhythm problems.

Tell the dialysis staff at once if you feel faint, have chest pain, palpitations, breathlessness, confusion, severe cramps or tingling during or after a session.

Pregnancy and Lactation

Pregnant women on dialysis need specialist care, often with adjusted bicarbonate levels and more frequent sessions. Dialysis can continue during breastfeeding as directed by the kidney team.

Precautions and Warnings

• Check that the correct concentrate or cartridge is used with the matching acid concentrate and machine settings.
• Prepared bicarbonate solution should be used promptly, as it can lose carbon dioxide and support bacterial growth over time.
• Water must meet dialysis quality standards.
• Blood bicarbonate and salt levels are monitored regularly.

Overdose

Overdose in the usual sense does not apply. Wrong concentration can cause alkalosis or salt imbalance; dialysis machines have alarms, and staff stop and correct the treatment.

Therapeutic Class

Haemodialysis solution concentrate (bicarbonate component); alkalinising agent.

Storage

Store as directed on the pack, usually below 30°C in a dry place; do not freeze liquid concentrates. Keep containers and cartridges sealed until use. Kept in dialysis units, out of the reach of children.