Haemodialysis in the treatment of lactic acidosis associated with acute hepatic and renal failure.

APPROXIMATELY one third of endogenous lactate is normally metabolized in the liver. In acute liver failure, accumulation of non-metabolized pyruvate and lactate results in high blood pyruvate and lactate levels (Tholen et al., 1966). Often in this condition it is possible to control the arterial pH by the administration of sodium bicarbonate or THAM; if however there is also renal failure or marked secondary aldosteronism, the administration of large amounts of sodium and fluid is limited. Under these circumstances, haemodialysis offers a means of correcting the acidosis without increase of extracellular volume and with removal of lactate.