The effect of first session dialysis on acid
base status in patients with renal failure
Keywords:
Acid-Base, Kidneys, HemodialysisAbstract
Background: MA results from the inability of the kidneys to eliminate acid load, leading to HCO3- depletion and accumulation of H+, the more deterioration of renal function the more severity of acidosis, In AKI, acidosis is a traditional and typical complication, and refractory acidosis is an indication for renal replacement therapy. Aim: to study the effect of first dialysis session on acidosis correction. Methods: an interventional study included 33 patients with renal failure presented for 1st time dialysis, we calculated the change in their pH, HCO3-, BD, AG and Cl- to Na+ ratio caused by dialysis, and studied whether or not this change is related to URR. Results: dialysis had significant effect on pH, HCO3- and BD, and there was positive correlation between URR and HCO3- difference and negative correlation between both BD difference with HCO3- difference, and BD difference with HCO3- difference. Conclusion: 1st dialysis session has significant effect on acidosis correction without affecting electroneutrality of the blood.
Downloads
References
Kellum JA. Determinants of blood pH in health and disease. Critical care. 2000 Feb;4(1):1-9.
Quigley R, Baum M. Neonatal acid base balance and disturbances. InSeminars in perinatology 2004 Apr 1 (Vol. 28, No. 2, pp. 97-102). WB Saunders.
Shaw JC. Nonmetabolizable base balance: effect of diet composition on plasma pH. The Journal of nutrition. 1989 Dec 1;119(suppl_12):1789-98.
Alberti KG, Cuthbert C. The hydrogen ion in normal metabolism: a review. Metabolic acidosis. 1982:1-5.
Poupin N, Calvez J, Lassale C, Chesneau C, Tomé D. Impact of the diet on net endogenous acid production and acid–base balance. Clinical nutrition. 2012 Jun 1;31(3):313-21.
Lemann J, Litzow JR, Lennon EJ. The effects of chronic acid loads in normal man: further evidence for the participation of bone mineral in the defense against chronic metabolic acidosis. The Journal of clinical investigation. 1966 Oct 1;45(10):1608-14.
Bushinsky DA. Acid-base imbalance and the skeleton. European journal of nutrition. 2001 Oct;40(5):238-44.
Adrogué HE, Adrogue HJ. Acid-base physiology. Respiratory care. 2001 Apr 1;46(4):328-41.
Raphael KL. Metabolic acidosis in CKD: core curriculum 2019. American Journal of Kidney Diseases. 2019 Aug 1;74(2):263-75.
Elkington JR. Hydrogen ion turnover in health and disease. Ann Intern Med.
;57:660-84.
Lee SA, Cozzi M, Bush EL, Rabb H. Distant organ dysfunction in acute kidney injury: a review. American Journal of Kidney Diseases. 2018 Dec 1;72(6):846-56.
Emmett M. Anion-gap interpretation: the old and the new. Nature clinical practice nephrology. 2006 Jan;2(1):4-5.
Chan YL, Savdie E, Mason RS, Posen S. The effect of metabolic acidosis on vitamin D metabolites and bone histology in uremic rats. Calcified Tissue International. 1985 Mar;37(2):158-64.
Kleger GR, Turgay M, Imoberdorf R, McNurlan MA, Garlick PJ, Ballmer PE. Acute metabolic acidosis decreases muscle protein synthesis but not albumin synthesis in humans. American journal of kidney diseases. 2001 Dec 1;38(6):1199-207.
Razak MK, Rasheed JI, Meizel MM. The Effect of Acidosis on Albumin Level in Patients Treated with Regular Hemodialysis (Single Center Study). Global Journal of Health Science. 2018;10(11):1-57.
DeFronzo RA, Beckles AD. Glucose intolerance following chronic metabolic acidosis in man. American Journal of Physiology-Endocrinology and Metabolism. 1979 Apr 1;236(4):E328.
Sonikian M, Gogusev J, Zingraff J, Loric S, Quednau B, Bessou G, Siffert W, Drüeke TB, Reusch HP, Luft FC. Potential effect of metabolic acidosis on beta 2-microglobulin generation: in vivo and in vitro studies. Journal of the American Society of Nephrology. 1996 Feb 1;7(2):350-6.
Kellum JA, Song M, Li J. Lactic and hydrochloric acids induce different patterns of inflammatory response in LPS-stimulated RAW 264.7 cells. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2004 Apr;286(4):R68692.
Raphael KL, Zhang Y, Wei G, Greene T, Cheung AK, Beddhu S. Serum bicarbonate and mortality in adults in NHANES III. Nephrology Dialysis Transplantation. 2013 May 1;28(5):1207-13.
Berend K, de Vries AP, Gans RO. Physiological approach to assessment of acid–base disturbances. New England Journal of Medicine. 2014 Oct 9;371(15):1434-45.
Stewart PA. Modern quantitative acid–base chemistry. Canadian journal of physiology and pharmacology. 1983 Dec 1;61(12):1444-61.
Ibrahim I, Chor WP, Chue KM, Tan CS, Tan HL, Siddiqui FJ, Hartman M. Is arterial base deficit still a useful prognostic marker in trauma? A systematic review. The American journal of emergency medicine. 2016 Mar 1;34(3):626-35.
Wallia R, Greenberg A, Piraino B, Mitro R, Puschett JB. Serum electrolyte patterns in end-stage renal disease. American Journal of Kidney Diseases. 1986 Aug 1;8(2):98-104.
Oettinger CW, Oliver JC. Normalization of uremic acidosis in hemodialysis patients with a high bicarbonate dialysate. Journal of the American Society of Nephrology. 1993 May 1;3(11):1804-7.
Faubel S, Shah PB. Immediate consequences of acute kidney injury: the impact of traditional and nontraditional complications on mortality in acute kidney injury. Advances in chronic kidney disease. 2016 May 1;23(3):179-85.
Harty J. Prevention and management of acute kidney injury. The Ulster medical journal. 2014 Sep;83(3):149.
Keshaviah PR, Nolph KD, Van Stone JC. The peak concentration hypothesis: a urea kinetic approach to comparing the adequacy of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. Peritoneal Dialysis International. 1989 Oct;9(4):257-60.
Casino FG, Lopez T. The equivalent renal urea clearance: a new parameter to assess dialysis dose. Nephrology Dialysis Transplantation. 1996 Aug 1;11(8):1574-81.
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, Herzog CA, Joannidis M, Kribben A, Levey AS, MacLeod AM. Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney international supplements. 2012 Mar;2(1):1-38.
Palevsky PM, Liu KD, Brophy PD, Chawla LS, Parikh CR, Thakar CV, Tolwani AJ, Waikar SS, Weisbord SD. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury. American Journal of Kidney Diseases. 2013 May 1;61(5):649-72.
Kopple JD. National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. American journal of kidney diseases. 2001 Jan 1;37(1):S66-70.
Liang KV, Zhang JH, Palevsky PM. Urea reduction ratio may be a simpler approach for measurement of adequacy of intermittent hemodialysis in acute kidney injury. BMC nephrology. 2019 Dec;20(1):1-7.
Leite Jr M, Leal E, Cardoso LR. Correction of acidosis by hemodialysis: proposal of a correlation with urea kinetics. Blood purification. 2002;20(6):551-6.
Lameire N, Van Biesen W. The initiation of renal-replacement therapy: Just-in-time delivery. New England Journal of Medicine. 2010;363(7):678-80.
Po HN, Senozan NM. The Henderson-Hasselbalch equation: its history and limitations. Journal of Chemical Education. 2001 Nov;78(11):1499.
Story DA. Bench-to-bedside review: A brief history of clinical acid–base. Critical Care. 2004 Aug;8(4):1-6.
Mehta AN, Emmett JB, Emmett M. GOLD MARK: an anion gap mnemonic for the 21st century. The lancet. 2008 Sep 13;372(9642):892.
Juern J, Khatri V, Weigelt J. Base excess: a review. Journal of Trauma and Acute Care Surgery. 2012 Jul 1;73(1):27-32.
Djuraev, A. M., Alpisbaev, K. S., & Tapilov, E. A. (2021). The choice of surgical tactics for the treatment of children with destructive pathological dislocation of the hip after hematogenous osteomyelitis. International Journal of Health & Medical Sciences, 5(1), 15-20. https://doi.org/10.21744/ijhms.v5n1.1813
Siggaard-Andersen O. The van Slyke equation. Scandinavian journal of clinical and laboratory investigation. 1977 Jan 1;37(sup146):15-20.
Knutzen L, Svirko E, Impey L. The significance of base deficit in acidemic term neonates. American journal of obstetrics and gynecology. 2015 Sep 1;213(3):373-e1.
Owen Jr WF, Lew NL, Liu Y, Lowrie EG, Lazarus JM. The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. New England Journal of Medicine. 1993 Sep 30;329(14):1001-6.
Havlin J, Matousovic K, Schuck O, Charvat J, Horackova M. The use of sodium– chloride difference and chloride–sodium ratio in the evaluation of metabolic acidosis in critically ill patients. European journal of pediatrics. 2012 Nov;171(11):1719-.
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864
Hopkins E, Sanvictores T, Sharma S. Physiology, acid base balance. InStatPearls [Internet] 2021 Sep 14. StatPearls Publishing.
Rocktaeschel J, Morimatsu H, Uchino S, et al. Acid-base status of critically ill patients with acute renal failure: analysis based on Stewart-Figge methodology. Crit Care. 2003;7(4): R60. doi:10.1186/cc2333.
Daugirdas, John T., Peter G. Blake, and Todd S. Ing. Handbook of dialysis. Lippincott Williams & Wilkins, 2012.
Kraut JA, Kurtz I. Metabolic acidosis of CKD: diagnosis, clinical characteristics, and treatment. American journal of kidney diseases. 2005 Jun 1;45(6):978-93.
Jasso-Avila MI, Castro-Argüelles AA, Centeno-Del Toro SM, Rivera-López E, ValadezCastillo FJ. Base excess measured at hospital admission is useful for predicting diabetic ketoacidosis severity and resolution time in adult patients. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2022 Jan 4:102385.
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
