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Biochemical parameters in chronic renal failure.

R M Hakim1, J M Lazarus

  • 1Department of Medicine, Vanderbilt University, Nashville, TN 37232.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|March 1, 1988
PubMed
Summary

Biochemical changes in renal failure (RF) vary with severity. Early RF shows faster changes in hematocrit, total CO2 (tCO2), and urea compared to advanced stages. Hyperphosphatemia is not typical in early renal insufficiency.

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Area of Science:

  • Nephrology
  • Biochemistry
  • Internal Medicine

Background:

  • Renal insufficiency (RI) involves complex biochemical alterations.
  • Understanding these changes is crucial for patient management.
  • The rate of biochemical parameter change relative to creatinine levels requires further elucidation.

Purpose of the Study:

  • To analyze the rate of change of key biochemical parameters in relation to creatinine levels across different stages of renal failure.
  • To determine if hyperphosphatemia is a characteristic of early renal failure.

Main Methods:

  • Analysis of biochemical data from 911 patients with renal insufficiency.
  • Stratification of patients based on creatinine levels: early (<5 mg/dL), moderate (5-10 mg/dL), and advanced (>10 mg/dL).

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  • Calculation of the rate of change for hematocrit, total CO2 (tCO2), urea, chloride, anion gap, and phosphate per unit change in creatinine.

    • Main Results:

    • The rate of change for hematocrit, tCO2, and urea per unit increase in creatinine was significantly higher in early RF compared to moderate and advanced RF.
    • Chloride levels initially increased then decreased with advancing RF, while the anion gap consistently increased.
    • Serum phosphate levels rose steadily but remained below the normal upper limit in early RF without phosphate binders.

    Conclusions:

    • Biochemical parameters change at different rates depending on the severity of renal dysfunction.
    • Phosphate retention occurs in renal insufficiency, but hyperphosphatemia is not a defining feature of early renal failure.