[The characteristics of metabolic acidosis in aged patients with chronic renal failure].
The present study was designed to clarify the characteristics of metabolic acidosis in aged patients with chronic renal failure. The subjects consisted of ambulatory cooperative patients (19 males and 18 females). Their values of creatinine clearance (Ccr) varied from 6.8 to 107.5 ml/min/1.73 m2. The relationship of Ccr to acid-base and electrolyte disturbances was investigated. The estimations of normal values in acid-base and electrolyte composition were based on the method of Hoffmann. The results are summarized as follows: 1. A high incidence of metabolic acidosis was demonstrated in patients whose Ccr values were below 20 ml/min/1.73 m2. 2. A significant positive correlation of Ccr values and plasma levels of bicarbonate (p less than 0.001) and a significant inverse correlation of Ccr values and serum levels of chloride (p less than 0.01) were observed. 3. The values of the anion gap did not change, irrespective of Ccr values. 4. Serum concentrations of potassium were inversely correlated with plasma levels of bicarbonate (p less than 0.01). Hyperchloremic normal anion gap acidosis with hyperpotassemia was the characteristic feature of metabolic acidosis in aged patients with chronic renal failure. The normal anion gap could be explained by normophosphatemia or mild hyperphosphatemia, even in the patients with advanced renal failure.
Department of Endocrinology and Metabolism, Tokyo Metropolitan Geriatric Hospital.
H
H
Fujimaki
M
M
Shiraki
J
J
Inoue
T
T
Takahashi
H
H
Ito
D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000209:etiology / Q000378:metabolism*; D000368:Aged; D003404:Creatinine / Q000378:metabolism; D004573:Electrolytes / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism*; D008297:Male
D004573:Electrolytes; D003404:Creatinine