| Autor: |
Tyler B. Woodell, Dena E. Rifkin, David H. Ellison, Dan Negoianu, Jessica W. Weiss |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
Kidney Medicine, Vol 2, Iss 1, Pp 42-48 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2590-0595 |
| DOI: |
10.1016/j.xkme.2019.08.004 |
| Popis: |
Rationale & Objective: Excess morbidity and mortality are associated with both high and low serum bicarbonate levels in epidemiologic studies of patients with end-stage kidney disease (ESKD) receiving hemodialysis. The Kidney Disease Outcomes Quality Initiative (KDOQI) recommends modifying dialysate bicarbonate concentration to achieve a predialysis serum bicarbonate level ≥ 22 mmol/L, measured as total carbon dioxide (CO2). This practice assumes that total CO2 is an adequate surrogate for acid-base status, yet its surrogacy performance is unknown in ESKD. We determined acid-base status at the beginning and end of hemodialysis using total CO2 and pH and tested whether total CO2 is an appropriate surrogate for acid-base status. Study Design: Pilot study. Setting & Participants: 25 veterans with ESKD receiving outpatient hemodialysis. Tests Compared: pH, calculated bicarbonate level, and total CO2. Outcomes: The proportion of paired samples for which total CO2 misclassified acid-base status according to pH was determined. Bias of total CO2 was evaluated using Bland-Altman plots, comparing it to calculated bicarbonate. Results: Among 71 samples, mean pH was 7.41 ± 0.03 predialysis and 7.48 ± 0.05 postdialysis. Compared with interpretation of full blood gas profiles, 9 of 25 (36%) participants were misclassified as acidemic using predialysis total CO2 measures alone (total CO2 26 mmol/L but pH ≤ 7.42). Among paired samples in which predialysis total CO2 was |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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