The ratio of chloride to bicarbonate is a predictor of advanced metabolic acidosis in CKD stages G4 and G5

被引：0

作者：

Justyna Korus ^{[1
]}

Maciej Gołębiowski ^{[1
]}

Jakub Stojanowski ^{[2
]}

Maciej Szymczak ^{[2
]}

Marcelina Żabińska ^{[3
]}

Dorota Bartoszek ^{[3
]}

Katarzyna Kościelska-Kasprzak ^{[3
]}

Mirosław Banasik ^{[2
]}

Milena Ściskalska ^{[4
]}

Mariusz Kusztal ^{[2
]}

Tomasz Gołębiowski ^{[2
]}

机构：

[1] Wroclaw Medical University,Faculty of Medicine

[2] Wroclaw Medical University,Department and Clinic of Nephrology, Transplant Medicine and Internal Medicine

[3] Wroclaw University of Science and Technology,Department of Preclinical Sciences, Pharmacology and Medical Diagnostics, Faculty of Medicine

[4] Wroclaw Medical University,Department of Pharmaceutical Biochemistry, Faculty of Pharmacy

来源：

Scientific Reports | / 15卷 / 1期

关键词：

Metabolic acidosis; Bicarbonate, chloride, anion gap; CKD;

D O I：

10.1038/s41598-025-05633-6

中图分类号：

学科分类号：

摘要：

Metabolic acidosis is a common disorder in patients with chronic kidney disease (CKD). As eGFR decreases, a reciprocal decrease in bicarbonate (HCO3−) and an increase in chloride (Cl−) concentration is observed. The aim of this study is to determine whether the Cl−/HCO3− ratio can be used to predict metabolic acidosis with pH decline. A total of 115 patients (age 63 ± 17 years), with CKD stage G4 or G5 were enrolled in this cross-sectional study. The arterial (A) and venous (V) blood samples were taken during AV fistula creation and evaluated in a point of care testing analyzer. The ratio of arterial Cl− and HCO3− concentration were calculated. According to mean arterial pH (pH-A) the group was divided into group with pH-A ≤ 7.33 and with pH-A > 7.33. The group with pH-A ≤ 7.33 showed significantly lower HCO3−, and higher Cl−, Cl−/HCO3−-ratio than group with pH-A > 7.33. Cl−/HCO3−-A ratio negatively correlated with pH (r=-0.77,p < 0.01). The discriminative power of Cl−/HCO3−-A ratio for predicting pH-A ≤ 7.33 was 0.917 ([CI] = 0.87–0.97,p < 0.01) which provided 87% sensitivity and 84% specificity. The best cut-off was 6.22(mmol/l)/(mmol/l). In conclusion, a Cl−/HCO3− ratio higher than 6.22(mmol/l)/(mmol/l) may be used as predictor of advanced metabolic acidosis in CKD stages G4 and G5.

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