ACIDIC HD CONCENTRATE SW 139A Dialysis Fluid

What is ACIDIC HD CONCENTRATE SW 139A

ACIDIC HD CONCENTRATE SW 139A is a dialysis fluid concentrate used in the treatment of patients with chronic kidney disease undergoing hemodialysis. It is formulated as an acidic component of a two- or three-part hemodialysis solution, which, when diluted appropriately, forms a complete dialysate. This dialysate facilitates the removal of waste products, excess electrolytes, and fluids from the blood of patients whose kidneys are no longer able to perform these functions naturally.

• Form: Liquid concentrate for dilution
• Packaging: 6 Liter Canister
• Generic components:
  • Acetic acid (glacial)
  • Calcium chloride dihydrate
  • Glucose monohydrate
  • Magnesium chloride hexahydrate
  • Potassium chloride
  • Sodium chloride

This solution is mixed with purified water and a bicarbonate concentrate to achieve the final dialysate composition needed for each patient, which is determined based on individual clinical needs. ACIDIC HD CONCENTRATE SW 139A plays a vital role in correcting acid-base balance, managing electrolyte levels, and supporting metabolic homeostasis during dialysis therapy.

How to use ACIDIC HD CONCENTRATE SW 139A

The use of ACIDIC HD CONCENTRATE SW 139A requires strict adherence to established dialysis protocols and should only be handled by trained healthcare professionals in a clinical setting. It must never be administered directly to the patient without dilution.

• Step 1: Preparation
  • Ensure the canister is intact, properly labeled, and within its expiry date.
  • Connect the canister to the dialysis machine according to the manufacturer’s instructions.
  • Use appropriate connectors and verify secure fittings to avoid leaks.
• Step 2: Dilution
  • The concentrate must be diluted with purified water and a bicarbonate solution to create a ready-to-use dialysate.
  • Standard dilution ratios (e.g., 1+34) are applied by automated dialysis machines.
• Step 3: Monitoring
  • Continuously monitor the conductivity and temperature of the dialysate during treatment.
  • Confirm the final composition matches the prescribed concentrations of electrolytes.
• Step 4: Post-use care
  • Dispose of the empty canister as per biohazard protocols.
  • Ensure the dialysis machine is cleaned and disinfected after treatment.

Patient-specific adjustments (such as potassium or calcium levels) may be made based on clinical condition. This concentrate must be used in conjunction with a bicarbonate concentrate and should never be infused directly into the bloodstream.

Mode of Action ACIDIC HD CONCENTRATE SW 139A

ACIDIC HD CONCENTRATE SW 139A functions as part of the dialysate system in hemodialysis, working through diffusion and convection across a semi-permeable membrane in the dialyzer to cleanse the blood.

• Acetic Acid (Glacial): Serves to acidify the dialysate, helping to correct metabolic acidosis by indirectly forming bicarbonate after metabolism.
• Electrolytes (Sodium, Potassium, Calcium, Magnesium): Maintain proper plasma electrolyte concentrations by allowing diffusion between blood and dialysate.
• Glucose: Provides an osmotic gradient to aid in fluid removal (ultrafiltration) during dialysis sessions.
• Chloride Ions: Balance the anion content and maintain electrical neutrality in the solution.

The dialysate produced by mixing this concentrate with a bicarbonate solution and purified water establishes a concentration gradient between the dialysate and the patient’s blood. This gradient enables:

• Removal of uremic toxins (e.g., urea, creatinine)
• Correction of electrolyte imbalances (especially sodium, potassium, calcium)
• Control of acid-base status through the buffering action of bicarbonate formed from acetic acid

Overall, the solution plays a vital role in supporting the physiological balance in patients undergoing maintenance hemodialysis.

ACIDIC HD CONCENTRATE SW 139A Interactions ACIDIC HD CONCENTRATE SW 139A

As ACIDIC HD CONCENTRATE SW 139A is not administered directly but used to prepare dialysate, its potential for systemic drug interactions is indirect. However, it can influence the pharmacokinetics of other drugs during dialysis treatment by altering fluid and electrolyte levels.

• Drugs Affected by Electrolyte Changes:
  • Digitalis glycosides: Hypokalemia or hypomagnesemia induced by dialysis may increase the risk of digitalis toxicity.
  • Antiarrhythmics (e.g., quinidine): Altered potassium and calcium levels may affect cardiac conduction.
• Antihypertensive Agents:
  • Dialysis can reduce plasma volume, which may potentiate the hypotensive effects of antihypertensives.
• Electrolyte Supplements:
  • Patients receiving potassium or calcium supplements may require dosage adjustments based on the dialysate composition.
• Insulin and Oral Hypoglycemics:
  • Dialysate glucose can affect glycemic control; dosage adjustments of antidiabetics may be necessary.

Clinical monitoring is essential to prevent drug accumulation or excessive clearance. Always review the patient's full medication list and dialysis prescription to anticipate and manage interactions appropriately.

Dosage of ACIDIC HD CONCENTRATE SW 139A

ACIDIC HD CONCENTRATE SW 139A is not dosed like a typical medication but is rather mixed in specific ratios to create a final dialysate solution. The dosage depends on the individual patient's dialysis prescription.

• Typical Mixing Ratio:
  • 1 part acidic concentrate + 1 part bicarbonate concentrate + 34 parts purified water
  • Automated dialysis machines manage the mixing to ensure consistent dialysate composition
• Final Dialysate Composition (approximate):
  • Sodium: 136–140 mmol/L
  • Potassium: 2–3 mmol/L (adjustable)
  • Calcium: 1.25–1.75 mmol/L
  • Magnesium: 0.5 mmol/L
  • Glucose: 5.5 mmol/L (varies)
  • Acetate: ~3 mmol/L (buffer precursor)
• Volume:
  • The total dialysate volume used during each session ranges from 90 to 120 liters over 3–5 hours.

The dialysis team tailors electrolyte levels and session duration based on patient lab results, clinical status, and comorbid conditions.

Possible side effects of ACIDIC HD CONCENTRATE SW 139A

Since ACIDIC HD CONCENTRATE SW 139A is used indirectly as a component of dialysate, its side effects are usually related to the composition of the final dialysate solution and how it interacts with the patient’s physiology during hemodialysis.

• Electrolyte Imbalances:
  • Hypokalemia or hyperkalemia
  • Hypercalcemia or hypocalcemia
  • Hypomagnesemia
• Acid-Base Disturbances:
  • Metabolic alkalosis (especially if acetate conversion is excessive)
• Hypoglycemia or Hyperglycemia:
  • Dependent on glucose concentration in the dialysate and patient’s diabetic status
• Dialysis-related Symptoms:
  • Nausea
  • Muscle cramps
  • Headache
  • Fatigue or hypotension

Severe reactions are rare when the dialysate is prepared correctly. Continuous monitoring and individualized dialysis prescriptions are key to minimizing these side effects.

ACIDIC HD CONCENTRATE SW 139A Contraindications ACIDIC HD CONCENTRATE SW 139A

ACIDIC HD CONCENTRATE SW 139A should not be used in certain clinical scenarios where components of the solution may exacerbate pre-existing conditions.

• Absolute Contraindications:
  • Hypersensitivity to any of the ingredients (e.g., acetic acid, glucose)
  • Severe hypotension that may be worsened by dialysis
  • Patients with known acetate intolerance
• Relative Contraindications:
  • Uncontrolled hyperkalemia or hypokalemia
  • Severe fluid overload unresponsive to ultrafiltration
  • Active bleeding with anticoagulant use during dialysis

In all cases, therapy should be tailored, and alternative dialysis solutions considered when contraindications are present. Regular clinical evaluations are essential for safe use.

Storage of ACIDIC HD CONCENTRATE SW 139A

Proper storage of ACIDIC HD CONCENTRATE SW 139A is essential to maintain its chemical stability and prevent contamination, ensuring safe and effective use during dialysis sessions.

• Temperature:
  • Store at 15°C to 30°C (59°F to 86°F)
  • Do not freeze
• Container Guidelines:
  • Keep the 6-liter canister tightly sealed when not in use
  • Use aseptic technique when connecting to the dialysis machine
• Shelf Life:
  • Refer to the manufacturer’s labeling for expiration date
  • Do not use after the expiration date
• After Opening:
  • Single-use only; discard any unused portion after session
• Protection:
  • Store away from direct sunlight and extreme humidity
  • Prevent exposure to contaminants by maintaining a clean environment

Following manufacturer instructions and maintaining proper storage conditions helps ensure patient safety and solution efficacy.