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there are two types of concentrates (based on the main basic anion) that are used: acetate concentrate: this contains all the necessary components shown in the table. the basic anion is sodium acetate. in the early days, bicarbonate could not be used as it reacted with calcium, to form insoluble calcium carbonate and acetate was used in its place. with the use of more efficient dialyzers in the mid-1970s, however, problems with acetate toxicity arose. this meant that acetate had to be replaced with bicarbonate, and a new proportioning system was developed. currently the use of acetates dialysate is very limited. bicarbonate concentrate: in order to use bicarbonate as the basic anion the dialysate concentrate is made in two parts. part a, (acid concentrate) contains all of the electrolytes (except sodium bicarbonate) and glucose as given in the table below, while part b contains sodium bicarbonate in concentrated solution. appropriate proportions of a and b are pumped into two proportioning system were they are mixed with water to produce the final dialysate concentrations. a and b dialysate are then mixed together to form the final dialysate. usually , the bicarbonate solution is 20 times concentrated , thus one part is diluted with 19 parts water by the proportioning system. acid concentrate is either 34 times or 44 times concentrated
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