Acid-base balance in dialysis patients
1Department of Medicine, University of Vermont College of Medicine, Burlington, USA. fgennari@zoo.uvm.edu
Seminars in Dialysis
|August 3, 2000
Summary
Dialysis patients often have low serum bicarbonate, indicating acidosis. Patients with bicarbonate below 19 mEq/L require intervention to correct acidosis, while those between 19-24 mEq/L need further study.
Area of Science:
- Nephrology
- Biochemistry
- Internal Medicine
Background:
- Acid-base balance in dialysis patients is complex, influenced by renal replacement therapy and dialysis bath composition.
- Despite advancements, many hemodialysis and peritoneal dialysis patients exhibit low pre-dialysis serum bicarbonate levels.
- The impact of mild acidosis on morbidity and mortality in end-stage renal disease (ESRD) is a critical concern.
Purpose of the Study:
- To review the acid-base equilibrium in patients undergoing hemodialysis and peritoneal dialysis.
- To evaluate the benefits of correcting acidosis in dialysis patients.
- To explore methods for increasing serum bicarbonate levels in these patients.
Main Methods:
- Review of existing literature on acid-base balance in renal replacement therapy.
- Analysis of factors influencing serum bicarbonate in dialysis patients.
- Discussion of diagnostic and therapeutic strategies for acidosis management.
Main Results:
- Pre-dialysis serum bicarbonate is frequently below normal in hemodialysis and peritoneal dialysis patients.
- A serum bicarbonate level below 19 mEq/L warrants assessment and intervention to correct acidosis.
- The necessity of intervention for bicarbonate levels between 19 and 24 mEq/L requires further investigation.
Conclusions:
- Acid-base balance is a crucial consideration in dialysis patient management.
- Prompt assessment and correction of significant acidosis (HCO3- < 19 mEq/L) are recommended.
- Further research is needed to determine optimal bicarbonate targets for dialysis patients.
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