AHCD 1st Edition

Adult administration

(A solution 1 : B solution 1.26 : Purified Water 32.74) is the dilution ratio for use as a perfusion solution during hemodialysis using the bicarbonate-type dialysis supply system. The volume varies depending on dialysis time, but typically 150-300L is used as a perfusion solution.

This drug should be used cautiously in patients with severe liver dysfunction or severe diabetes where acetate metabolism is not smooth. If acetate is not properly metabolized, symptoms of low blood pressure may occur. Patients taking digitalis preparations need to be cautious as the potassium level in the blood may drop, increasing the risk of drug toxicity. Patients with serum calcium levels above normal and very high serum phosphate levels may experience ectopic calcification when using this drug, requiring caution. Patients with insufficient calorie intake or those with dietary restrictions due to diabetes or using hypoglycemic agents may exhibit symptoms of hypoglycemia and should be careful. This drug can cause hypoglycemia during or after dialysis; therefore, appropriate measures such as immediate glucose injection or sugar supply should be taken if hypoglycemic symptoms appear. Due to the risk of increased blood calcium levels, it is advisable to switch to a low-calcium dialysis solution if hypercalcemia is suspected. Complications related to bones such as osteoporosis, osteomalacia, and fibrous osteitis may occur, necessitating treatment with activated vitamin D3 preparations if these symptoms appear. Ectopic calcification may occur, so appropriate measures such as administering phosphate binders should be taken to maintain serum phosphate levels within the normal range. Dialysis disequilibrium syndrome may present with symptoms such as headache, nausea, vomiting, convulsions, and altered consciousness, requiring measures to reduce dialysis efficiency. It may affect the circulatory system, causing symptoms of low blood pressure or shock, necessitating discontinuation of dialysis or administration of fluids and blood pressure-raising agents when symptoms occur. Rarely, blood pressure elevation may occur, and administering antihypertensive drugs or switching to acetate-based dialysis solution may be beneficial. This drug is used for hemodialysis in patients with chronic kidney failure, especially when metabolic acidosis improvement is insufficient due to high acetate concentration or when dialysis management is difficult. It is used for patients with hyperglycemia who have difficulty controlling blood sugar without glucose-containing dialysis solutions. Regular blood tests are essential to check electrolytes, acid-base balance, kidney function, and blood sugar status. Safety during pregnancy has not been established, so women who are pregnant or may become pregnant should use it only when the benefits exceed the risks. Safety for children has also not been established, so caution is needed when used in children. Elderly patients should use this drug considering the drug characteristics, and regular examinations along with administration of activated vitamin D3 preparations are recommended to prevent bone complications during long-term use. Dialysis diluent water must be used that has undergone proper purification processes, and care should be taken regarding the possibility of dialysis membrane damage or bleeding tendencies. During preparation, the electrolyte solution for artificial kidney dialysis and sodium bicarbonate solution should not be directly mixed and should be exactly prepared using specified diluent. Before using the dialysis solution, check the electrolyte concentration and pH to ensure they are within appropriate ranges, and use immediately after dilution. Maintain the temperature at body temperature during use, and it should not be used for injection or peritoneal perfusion. It is essential to keep the osmolarity of the dialysis solution in balance with the serum osmolarity of dialysis patients.

Serious side effects

• Altered consciousness
• shock symptoms
• rapid drop in blood pressure

Mild side effects

• Hypoglycemia
• hypercalcemia
• osteoporosis
• osteomalacia
• fibrous osteitis
• ectopic calcification
• headache
• nausea
• vomiting
• malaise

This drug should be stored in a sealed plastic container at room temperature, preferably between 1 and 30 degrees. This storage method ensures the safety of the drug's effectiveness.

Appearance

Solution A: A colorless or pale yellow transparent liquid in a plastic container Solution B: A colorless transparent liquid in a plastic container

Package unit

Solution A: 10L/container, Solution B: 6.3L/container, 12.6L/container