Hemodialysis Concentrated Ii Acidic

What it is and how it works

This acidic concentrate contains sodium chloride, potassium, calcium and magnesium salts, a small amount of acid (acetic or citric acid) and often glucose. The dialysis machine mixes it in fixed proportions with purified water and a separate bicarbonate concentrate (‘B’ component) to produce bicarbonate dialysis fluid; the acid prevents precipitation of calcium and magnesium carbonate. Diffusion across the dialyser membrane removes uraemic solutes and corrects electrolyte and acid–base disturbances. The Roman numeral denotes a formulation with a specific electrolyte composition stated by the manufacturer.

Indications

Preparation of dialysis fluid for haemodialysis in acute kidney injury and chronic kidney failure, and for removal of certain dialysable toxins.

Dosage and administration (summary)

Not administered to the patient directly; it is used by the dialysis machine at the dilution ratio stated on the label, and the dialysis prescription is individualised by the nephrologist.

Warnings and precautions

Not for injection or infusion. It must be used only with the matching bicarbonate concentrate on machines set to the correct mixing ratio, and the conductivity and pH of the final dialysis fluid should be checked before treatment, because incorrect concentrate or mixing can cause serious electrolyte disturbances. Dilution water must meet dialysis water quality standards (e.g. ISO 23500), and the potassium and calcium content should be chosen according to the patient’s serum levels.

Storage and supply

Store at room temperature (usually 5–30 °C); do not freeze; keep containers closed until use.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.