Acetate intolerance during hemodialysis.

Acetate is frequently substituted for bicarbonate in hemodialysis solutions. Plasma acetate and bicarbonate concentrations were measured in nine patients with chronic renal failure undergoing hemodialysis with dialyzate containing acetate. In three patients (2 children and 1 adult) plasma acetate concentrations exceeded 15 mEq/liter during the dialysis. The mechanisms leading to acetate intolerance are probably multiple. It cannot be assumed that dialysis with acetate containing solutions will restore the buffer anion deficit characteristic of chronic renal failure.