Relationship between interdialytic weight gain and acid-base status in hemodialysis by bicarbonate

被引:14
作者
Agroyannis, B [1 ]
Fourtounas, C [1 ]
Tzanatos, H [1 ]
Dalamangas, A [1 ]
Vlahakos, DV [1 ]
机构
[1] Aretaieon Univ Hosp, Dept Nephrol, Athens 11528, Greece
关键词
uremic patients; bicarbonate dialysate; interdialytic weight gain;
D O I
10.1046/j.1525-1594.2002.06883.x
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
The aim of this study was to determine the relationship between interdialytic weight gain and acid-base balance pre- and posthemodialysis in uremic patients undergoing hemodialysis with a high bicarbonate dialysate (39 mmol/L). To this end we studied 8 stable uremic patients on regular hemodialysis thrice weekly who had stable hematocrit values for at least 3 months, similar clinical characteristics including dry weight but widely varying interdialytic weight gain. Arterial line blood samples were collected anaerobically in heparinized syringes pre- and posthemodialysis in 4 consecutive hemodialysis sessions for the determination of pH, Paco(2), and HCO3. Prehemodialysis values (mean +/- SD) were pH = 7.34 +/- 0.03, Paco(2) = 36.43 +/- 1.4, and HCO3 = 20.1 +/- 1.55. Posthemodialysis values were pH = 7.47 +/- 0.02, PaCco(2) = 38.72 +/- 2.0, and HCO3 = 27.73 +/- 1.72. In other words, patients were moderately acidemic prior to and moderately alkalemic after the hemodialysis session. Of note, a significant negative correlation was revealed between the interdialytic weight gain and the values of prehemodialysis blood pH (r = -0.721, p < 0.001) and HCO3 (r = -0.836, p < 0.001) and posthemodialysis pH (r = -0.533, p < 0.001), Paco(2) (r = -0.623, p < 0.001) and HCO3 (r = -0.815, p < 0.001), suggesting an important role of the interdialytic weight gain on acid-base equilibrium of uremic patients undergoing hemodialysis. Thus, patients with high interdialytic weight gains may require higher bicarbonate concentrations to achieve normal acid-base status whereas patients with low interdialyic weight gains may require lower bicarbonate concentrations to prevent alkalemia at the end of dialysis.
引用
收藏
页码:385 / 387
页数:3
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