How do GranuFlo and NaturaLyte work?

GranuFlo and NaturaLyte are concentrations of acetate or sodium diacetate (acetic acid plus acetate). They are formulated to be used with a three-stream hemodialysis machine, which is calibrated for acid and bicarbonate concentrates. Infusions of GranuFlo / NaturaLyte are meant to raise the serum bicarbonate level in patients undergoing hemodialysis to a proper pH balance. But if GranuFlo / NaturaLyte is administered in improper dosages, it can lead to a serum bicarbonate level that is too high.