Moderate metabolic acidosis and its effects on nutritional parameters in hemodialysis patients.
We screened the laboratory data of all of our chronic hemodialysis patients to identify 2 groups: 1) those with a pre-dialysis total CO2 concentration equal or less than 21 mEq/l (group A) and 2) those with a pre-dialysis total CO2 concentration equal or greater than 25 mEq/l (group B) and then both groups were compared for the following parameters: protein catabolic rate, dietary protein intake by dietary history, Kt/V, serum albumin, weight, pre-dialysis serum creatinine and pre-dialysis BUN. Patients from group A had a significantly lower age, a significantly higher protein catabolic rate and significantly higher values for pre-dialysis serum creatinine and BUN. The values for body weight, dietary protein intake and serum albumin were also higher in group A than in group B but the differences did not reach statistical significance. There was a good correlation between protein catabolic rate and pre-dialysis total CO2 and between the latter and serum albumin. These results suggest that moderately low pre-dialysis serum bicarbonate concentration is usually the result of high protein intake and should be of no concern in well-dialyzed patients with a protein catabolic rate greater than 1 g/kg/day. However, further studies are needed to confirm this conclusion.
Uribarri
J
J
Department of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
D000138:Acidosis / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D001806:Blood Urea Nitrogen; D002245:Carbon Dioxide / Q000097:blood; D003404:Creatinine / Q000097:blood; D006801:Humans; D008875:Middle Aged; D011506:Proteins / Q000378:metabolism*; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis
D011506:Proteins; D012709:Serum Albumin; D002245:Carbon Dioxide; D003404:Creatinine