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Changes in osmol gap in chronic kidney disease: an exploratory study
Gulvahid Shaikh1, Rahul Sehgal, Sukhdeep Sandhu
1Department of Medicine, Division of Nephrology and Hypertension, Nassau University Medical Center , East Meadow, NY , USA and.
Insights
The osmol gap (OG) increases with chronic kidney disease (CKD) progression and is elevated in patients undergoing maintenance hemodialysis (HD). Hemodialysis effectively normalizes the osmol gap, suggesting its utility in assessing CKD stage and dialysis adequacy.
Area of Science:
- Nephrology
- Clinical Chemistry
Background:
- Limited data exists on osmol gap (OG) in chronic kidney disease (CKD) by stage.
- Data on OG in adults on maintenance hemodialysis (HD) is scarce.
Purpose of the Study:
- To investigate the trend of OG across different stages of CKD.
- To compare pre- and post-hemodialysis OG in patients on maintenance HD.
Main Methods:
- A cross-sectional study involving 67 patients.
- Patients were categorized into six groups: normal renal function, CKD stages 2-5 (non-dialysis), and maintenance HD.
- Osmol gap was measured in all groups, with pre- and post-HD measurements for the HD group.
Main Results:
- A statistically significant upward trend in OG was observed with increasing CKD stage (p < 0.001).
- Patients on maintenance HD exhibited significantly higher OG compared to reference and CKD groups (p < 0.001).
- Hemodialysis significantly reduced OG in the HD group (p < 0.001).
Conclusions:
- Osmol gap demonstrates a significant positive correlation with CKD stage.
- Elevated OG in maintenance HD patients is normalized post-dialysis.
- OG may serve as a valuable biomarker for CKD staging and dialysis adequacy assessment.
Aim:
There is no data on osmol gap (OG) in chronic kidney disease (CKD) by stage and limited data on OG in adults on maintenance hemodialysis (HD). We aimed to examine the OG between different stages of CKD and to compare the OG pre- and post-HD in those on maintenance HD.
Methods:
We conducted a cross-sectional study of 67 patients. The participants were divided into six groups: Group 1-reference group (normal renal function), Group 2-CKD stage 2; Group 3-CKD stage 3; Group 4-CKD stage 4; Group 5-CKD stage 5 and not on dialysis. Group 6 were subjects on maintenance HD.
Results:
The means of OG ± standard deviation of Groups 1-6 were 15.25 ± 3.0, 20.73 ± 2.68, 22.85 ± 6.99, 24.11 ± 3.64, 25.15 ± 5.06, and 28.88 ± 3.45, respectively (p < 0.001). In the HD group, the difference between the pre-HD and post-HD OG was statistically significant (p < 0.001).
Conclusion:
There is a statistically significant upward trend for OG as CKD stage increases. The OG is elevated in patients on maintenance HD and is normalized by the HD. OG can be a valuable additional tool to suggest CKD stage and serve as a marker of dialysis adequacy.
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