title: Metabolic acidosis and its association with nutritional status in hemodialysis.
abstract: BACKGROUND
  Metabolic acidosis is a common problem in dialysis patients and plays an important role in the pathogenesis of protein-energy malnutrition in these patients.
  
  
  OBJECTIVE
  To assess the prevalence of metabolic acidosis in hemodialysis and search their association with nutritional status.
  
  
  METHODS
  A cross-sectional study was performed in hemodialysis patients at a single center. Nutritional status was assessed by anthropometric, biochemical and multifrequency bioelectrical impedance analysis. Metabolic acidosis was defined as serum bicarbonate (BIC) < 22 mEq/L and patients were divided into 3 groups according to BIC (< 15.15 to 21.9 and ≥ 22). The association between BIC and continuous variables was investigated using the Kruskal Wallis test. The linear correlation between BIC and the variables of the study was also tested.
  
  
  RESULTS
  We studied 95 patients, 59% male, mean age 52.3 years. The prevalence of metabolic acidosis was 94.7%. BMI, interdialytic weight gain and PTH were significantly different among the 3 groups of BIC. The BIC was negatively correlated with urea, phosphorus and interdialytic weight gain. There was no significant correlation with albumin, phase angle and lean body mass index.
  
  
  CONCLUSIONS
  The prevalence of metabolic acidosis was high in this population, and a lower BIC correlated with higher levels of urea, PTH, phosphorus, interdialytic weight gain and lower BMI. The evaluation of acid-basic status should be routinely implemented in dialysis patients by considering the negative effects of acidosis on the nutritional status, inflammation and bone disease.
authors.affiliation: UniChristus, Brazil.
authors.forename: Claudia Maria Costa
authors.initials: CM
authors.lastname: de Oliveira
authors.affiliation: UniChristus, Brazil.
authors.forename: Caroline Lustosa da Costa
authors.initials: CL
authors.lastname: Vidal
authors.affiliation: UniChristus, Brazil.
authors.forename: Eurinice Fontenele
authors.initials: EF
authors.lastname: Cristino
authors.affiliation: Universidade Federal do Ceará, Brazil.
authors.forename: Francisco Marto Leal
authors.initials: FM
authors.lastname: Pinheiro
authors.affiliation: UniChristus, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Kubrusly
mesh_terms: D000138:Acidosis / Q000150:complications*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D006435:Renal Dialysis / Q000009:adverse effects*