PMID: 18432583Apr 25, 2008Paper

Acid-base balance in combined severe hepatic and renal failure: a quantitative analysis

The International Journal of Artificial Organs
T NakaP Angus

Abstract

Severe hepatic failure (SHF) commonly leads to major changes in acidbase balance status. However, the direct effects of liver failure per se on acid base balance are poorly understood because this condition is usually associated with acute renal failure (ARF). To assess the effect of SHF on acid-base balance. Retrospective laboratory investigation. Thirty-seven critically ill patients with SHF complicated by ARF, and 42 patients with severe ARF without liver failure prior to renal replacement therapy. Retrieval of clinical and laboratory data from prospective unit and laboratory databases. Quantitative acid-base assessment using Stewart-Figge methodology. Comparison of findings between the two groups. Comparison of demographic and clinical features. Patients with combined SHF and ARF were younger and had significantly higher mean bilirubin, ALT and INR levels (p<0.0001). Their mean lactate concentration was higher (6.4 vs. 2.1 mmol/L; p<0.0001) leading to a greater anion gap (25.8 vs. 16.1 mmol/L; p<0.0001). The ionized calcium concentration (1.00 vs. 1.15 mmol/L; p<0.0001) was lower but the strong ion difference apparent (SIDa) was greater (42.0 vs. 38.0 mEq/L; p<0.005) due to hypochloremia. The albumin concentration was low b...Continue Reading

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Citations

Dec 31, 2008·The International Journal of Artificial Organs·G Catapano, J B Klein
Dec 29, 2009·The International Journal of Artificial Organs·Gerardo Catapano, Jon B Klein
Sep 29, 2018·SAGE Open Medicine·Satoshi KimuraHiroshi Morimatsu
Sep 24, 2020·Journal of Veterinary Internal Medicine·Diego E GomezRobert J Mackay
Dec 21, 2011·The International Journal of Artificial Organs·Inbyung KimRinaldo Bellomo
Jul 19, 2013·Wiener klinische Wochenschrift·Nikolaus KneidingerValentin Fuhrmann
Nov 4, 2020·Journal of Veterinary Internal Medicine·Diego E GomezDavid L Renaud

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