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Acid-base balance in continuous ambulatory peritoneal dialysis
Proceedings of the Clinical Dialysis and Transplant Forum
|January 1, 1980
Summary
Anuric patients undergoing continuous ambulatory peritoneal dialysis (CAPD) often develop metabolic acidosis due to bicarbonate loss in dialysate. Supplementing with bicarbonate effectively corrects this acid-base imbalance.
Area of Science:
- Nephrology
- Internal Medicine
- Critical Care Medicine
Background:
- Anuric patients undergoing continuous ambulatory peritoneal dialysis (CAPD) are susceptible to acid-base disturbances.
- Dialysate bicarbonate (HCO3-) loss is a known complication of CAPD.
- Metabolic acidosis can negatively impact patient outcomes.
Purpose of the Study:
- To investigate the presence and causes of metabolic acidosis in anuric CAPD patients.
- To assess the impact of dialysate HCO3- loss on base balance.
- To evaluate the efficacy of bicarbonate supplementation in correcting acidosis.
Main Methods:
- Patient group: Anuric patients on CAPD.
- Assessment: Measurement of acid-base balance and base balance.
- Intervention: Bicarbonate supplementation.
Main Results:
- Metabolic acidosis was confirmed in the studied CAPD patients.
- Dialysate HCO3- loss was identified as the primary cause of negative base balance (26.4 +/- 23.5 mMol/day).
- Bicarbonate supplementation successfully corrected the metabolic acidosis. Respiratory alkalosis was also noted in some patients.
Conclusions:
- Metabolic acidosis is a significant issue in anuric CAPD patients, primarily driven by dialysate bicarbonate loss.
- Bicarbonate supplementation is an effective treatment for correcting metabolic acidosis in this population.
- The presence of concurrent respiratory alkalosis warrants further investigation.