Depressant action of acetate upon the human cardiovascular system.

The effect of regular hemodialysis (HD) with dialyzate containing acetate was evaluated in 20 patients. After dialysis, a significant increase in limb blood flow was found (P less than 0.01) while the mean arterial blood pressure remained unchanged indicating a significant decrease in peripheral vascular resistance after HD (P less than 0.01). Cardiac function was evaluated using the ratio of the preejection period to left ventricular ejection time (PEP/ET); this value showed a significant increase after HD suggesting depression of cardiac function (P less than 0.001). The study was repeated substituting bicarbonate for acetate in 13 of the 20 patients. Under these conditions, limb blood flow and peripheral vascular resistance showed no significant change though mean arterial blood pressure decreased significantly (P less than 0.01). The ratio, PEP/ET, showed a significant increase after HD (P less than 0.01), but the value was significantly lower than that found after HD with dialyzate containing acetate (P less than 0.05). Changes in the serum levels of calcium, potassium, pH and body weight could not explain the differences found after HD with the two kinds of dialyzate. The results of the present study suggest strongly that acetate exerts a depressant action on the cardio-vascular system.