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[Changes in the anion gap in patients undergoing hemodiafiltration]
J Hernández-Jaras1, H García, J A Ferrero
1Servicio de Nefrología, Hospital General de Castellón.
Summary
Serum anion gap (AG) significantly decreases during online hemodiafiltration (HDF), primarily due to changes in albumin and phosphate levels. This study highlights how these factors can mask reductions in other unmeasured anions during HDF treatment.
Area of Science:
- Nephrology and Clinical Chemistry
- Biochemical analysis of renal replacement therapy
- Understanding acid-base balance in kidney disease
Context:
- Serum anion gap (AG) is a key diagnostic marker.
- Online hemodiafiltration (HDF) is a renal replacement therapy.
- Changes in AG during HDF require careful interpretation.
Purpose:
- To evaluate changes in serum anion gap (AG) during online HDF.
- To identify the contribution of various components to the AG.
- To assess the impact of HDF on unmeasured anions.
Summary:
- Online HDF significantly reduced serum AG from 23.1 to 17.3 mEq/l.
- Serum albumin's negative charge (CAA) increased, contributing more to the AG post-HDF.
- Unmeasured anions (UA) decreased significantly, but this was partly masked by albumin changes.
Impact:
- The study reveals that increased serum albumin can mask decreased unmeasured anions during HDF.
- An adjusted AG calculation is proposed to better reflect changes in undetermined anions.
- Findings aid in more accurate interpretation of metabolic changes in HDF patients.