title: Analysis of Arterial Blood Gas Report in Chronic Kidney Diseases - Comparison between Bedside and Multistep Systematic Method.
abstract: BACKGROUND
  Acid Base Disorders (ABDs) are commonly encountered in critically ill Chronic Kidney Disease (CKD) patients. Timely and correct analysis of Arterial Blood Gases (ABG) is critical for the diagnosis, treatment and prediction of outcome of the patients.
  
  
  OBJECTIVE
  The aim was to explore type and prevalence of ABDs in 31 critically ill CKD patients from a tertiary care hospital in Maharashtra, to compare two methods of analysis- bedside and systematic approaches and to clinically correlate the nature of ABDs in these patients.
  
  
  METHODS
  The initial ABG reports of 31 consecutive CKD patients were analysed by two methods. Medica Easy stat analyser was the equipment for analysis with Principle of potentiometry and ion selective electrode for pH and pCO2 and amperometry for pO2. Serum albumin was also measured by Bromocresol green dye binding method using liquixx albumin kit in Erba XL 300 autoanalyser.
  
  
  METHODS
  Chi-square test was used for statistical analysis using Epi Info version 3.5.4 and SPSS 14.0 softwares.
  
  
  RESULTS
  The systematic method showed a significantly higher prevalence of mixed disorders (50%) compared to bedside method (12.9%). Most prevalent disorder by bedside method was metabolic acidosis in 15 cases (48.39%). By the systematic method, 3 reports were invalid. As a single category, most prevalent type was both simple respiratory alkalosis and mixed metabolic acidosis with respiratory alkalosis- 6 of 31 cases in each type (19.36% each). As a whole, metabolic acidosis (including both High Anion Gap Metabolic Acidosis or HAGMA and Non Anion Gap Metabolic Acidosis or NAGMA with 4 in each type) was most prevalent- 8 of 31(25.8%).
  
  
  CONCLUSIONS
  Systematic approach was more effective in diagnosing mixed acid base disorders. By systematic method the findings of analysis in most cases could be correlated with the clinical condition and provisional diagnosis. Thus interpretation of ABDs by using stepwise approach could be useful to the clinicians in early diagnosis and management of the patients.
authors.affiliation: Resident, Department of Biochemistry, Dr D Y Patil Medical College , Pimpri, Pune, Maharashtra, India .
authors.forename: Ishita
authors.initials: I
authors.lastname: Ghatak
authors.affiliation: Professor, Department of Biochemistry, Dr D Y Patil Medical College , Pune, Maharashtra, India .
authors.forename: Vaishali
authors.initials: V
authors.lastname: Dhat
authors.affiliation: Professor and Head, Department of Biochemistry, Dr D Y Patil Medical College , Pune, Maharashtra, India .
authors.forename: Mona A
authors.initials: MA
authors.lastname: Tilak
authors.affiliation: Medical Officer in Charge-Government Blood Bank, Chandannagar SD Hospital , Government of West Bengal, India .
authors.forename: Indranath
authors.initials: I
authors.lastname: Roy
keywords: Acid base disorders; Metabolic acidosis; Mixed acid base disorders