title: [[Na+] - [Cl-] difference significantly contributes to acidemia in patients with liver cirrhosis].
abstract: To evaluate the role of strong ion difference (SID) in acid-base disorders in patients with liver disease.
  
  
  
  We evaluated the acid-base status in 11 patients with liver cirrhosis both by traditional and quantitative Stewart-Fencl methods.
  
  
  
  Nine of eleven patients had pH within the norm, 2/11 had pH above 7.44. One patient had respiratory alkalosis, the second had a combined respiratory alkalemia and metabolic acidemia. The anion gap was increased only in one patient, but after correction for serum albumin concentration, it was above the norm in 10/11 patients. pCO2 was below the normal limit in 5/11 patients. The Stewart-Fencl evaluation revealed decreased SID in 11/11 patients. Both SID and the difference in [Na+] - [Cl-] closely correlated with [HCO3-] (r = 0.9264 and r = 0.7272, respectively, P < 0.01). The not routinely assayed ions [UA-] were increased in 9/11 patients.
  
  
  
  The acid-base status in patients with decompensated liver cirrhosis was characterized by a tend-ency to respiratory alkalemia and metabolic acidemia. Apart from an increase of [UA-], the difference in [Na+] - [Cl-] con-tributed significantly to acidemia. Thus, this simple parameter aids in determining the causes of acid-base disturbance and influences the treatment strategy.Key words: acid-base balance - liver cirrhosis - sodium-chloride difference - Stewart-Fencl method.
authors.forename: Jana
authors.initials: J
authors.lastname: Lůžková
authors.forename: Bořivoj
authors.initials: B
authors.lastname: Lůžek
authors.forename: Karel
authors.initials: K
authors.lastname: Matoušovic
mesh_terms: D000136:Acid-Base Equilibrium; D000137:Acid-Base Imbalance; D000138:Acidosis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D012964:Sodium / Q000097:blood
chemical_list: D012964:Sodium