Kinetics of Infused Acetate and Effect on Plasma Pyruvate and Lipid Concentrations in Uremic and Non-Uremic Dogs

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Abstract
During acetate infusion at a rate of 10 millimoles/kg/hr arterial blood acetate levels rose progressively to maximums of 7.9 ± 1.7 mM in uremic dogs and 10.8 ± 1.4 mM in non-uremic dogs. Following cessation of infusion, removal of acetate followed first order kinetics. Acute uremia had no significant effect on mean clearance rates of acetate (1.28 ± 0.28 L/kg/hr uremics vs 0.92 ± 0.22 in non-uremics) or upon blood half-life of acetate following infusion (9.7 min. vs 10.9 min.). Plasma pyruvate levels rose during infusion from 1. 5 to 4. 4 mg/dl in the uremic dogs and following infusion rose further to 6. 5 mg/dl. In the non-uremic dogs pyruvate was not significantly elevated until 30 min. post-infusion. Plasma free fatty acids increased from 79 to 131 μ moles/dl during acetate infusion in the uremic dogs, but did not change significantly in the non-uremic group. Plasma cholesterol and triglycerides increased after induction of uremia, but showed no significant changes as a result of acetate infusion in either group. These results suggest that the electrolyte and lipid abnormalities that occur in hemodialyzed uremic patients may be related to the acetate load these patients receive during dialysis.