The effect of hemodialysis on electrolytes and acid-base parameters

Clinica Chimica Acta; International Journal of Clinical Chemistry
Barry Kirschbaum

Abstract

Hemodialysis patients are treated with bicarbonate dialysate to correct the metabolic acidosis, which results from the metabolism of dietary and endogenous protein. The concentration of plasma tCO(2) is used to gauge the success of therapy. Reported low values in pre-dialysis blood suggest incomplete correction of acidosis in a substantial percent of the dialysis population. However, questions have been raised about the reliability of tCO(2) determination in dialysis patients. Pre- and post-dialysis blood specimens were obtained from chronic hemodialysis patients and analyzed on-site using an OPTI Critical Care Analyzer. Results were compared with reports obtained monthly from the reference laboratory to which the samples were routinely shipped for analysis. In addition, OPTI analyzer whole blood electrolytes were compared with plasma electrolytes determined in a local laboratory. Mid-week testing of patients dialyzed against a 40-mmol/l bicarbonate dialysate found that most patients had normal acid-base status pre-dialysis and frank metabolic alkalosis by the end of dialysis. Whole blood tCO(2) values determined on the OPTI CCA were 2.4 mmol/l greater than heparin plasma tCO(2) assayed on the Vitros chemistry analyzer. Small d...Continue Reading

References

Mar 29, 2002·Kidney International·Warren P PickeringJohn Walls
Aug 3, 2002·European Journal of Clinical Investigation·R G RobertsT H J Goodship
Jan 25, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Graham WoodrowMichael A Smith

Citations

Jul 11, 2007·Journal of Materials Science. Materials in Medicine·Bai-hai SuChang-sheng Zhao
Mar 24, 2007·Pharmaceutical Research·Valentine WascotteVéronique Préat
Jul 6, 2014·Seminars in Dialysis·Jeffrey A Kraut, Glenn T Nagami
Apr 30, 2004·Clinica Chimica Acta; International Journal of Clinical Chemistry·Barry Kirschbaum
Jul 26, 2006·European Journal of Internal Medicine·R DerksenJ G van der Hoeven
May 28, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Tadashi YamamotoYoshiharu Tsubakihara
Oct 4, 2007·Asian Cardiovascular & Thoracic Annals·Naoki YoshimuraMasahiro Yamaguchi
Nov 1, 2005·Personalized Medicine·Sarah BacusYosef Yarden
Mar 2, 2013·Equine Veterinary Journal. Supplement·S H TinklerP D Constable

Related Concepts

Anion Gap
Blood Gas Analysis
Electrolytes
Hemodialysis
Kidney Failure, Chronic
Water-Electrolyte Balance

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