Abstract | BACKGROUND: METHODS: We studied 19 intermittent hemodialysis procedures in 17 acidotic patients. The patients were grouped by procedure type (conventional or sustained low-efficiency dialysis) and by predialysis plasma chloride level (higher or lower than the dialysate chloride concentration). Immediately before and after each procedure, blood samples were collected for biochemical analysis. The Stewart method was used to calculate the strong ion difference and strong ion gap. RESULTS: The patients presented acidosis related to hyperchloremia, hyperphosphatemia, and high unmeasured anions. Hypoalbuminemia had an alkalinizing effect. Hemodialysis corrected acidosis mainly by reducing phosphate and unmeasured anions. In the group as a whole, chloride levels did not change after dialysis. However, when analyzed according to predialysis plasma chloride, the high- chloride group presented a reduction in plasma chloride, resulting in better base excess improvement (Delta standard base excess) than in the low- chloride group. Among the determinants of acid-base status, the only factors correlating with Delta SBE were Delta strong ion gap and Delta chloride. CONCLUSION:
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Authors | Alexandre Braga Libório, Cristianne da Silva Alexandre, Danilo Teixeira Noritomi, Lúcia Andrade, Antonio Carlos Seguro |
Journal | Journal of critical care
(J Crit Care)
Vol. 21
Issue 4
Pg. 333-8
(Dec 2006)
ISSN: 0883-9441 [Print] United States |
PMID | 17175420
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Acidosis
(complications, metabolism, therapy)
- Aged
- Chlorides
(metabolism)
- Female
- Humans
- Linear Models
- Male
- Middle Aged
- Prospective Studies
- Renal Dialysis
- Renal Insufficiency
(etiology, therapy)
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