Document Detail


Acid-base profile in patients on PD.
MedLine Citation:
PMID:  14870875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acid-base profile in patients on PD. Secular trends in dialysis dose in peritoneal dialysis (PD) and modes of dialysis delivery [automated PD (APD) versus continuous ambulatory PD (CAPD)] require a reexamination of acid-base status in patients treated with these renal replacement modalities. We explored steady-state acid-base profile and its determinants in 175 patients on CAPD and 77 patients on APD. The majority (62% to 70%) of patients had serum bicarbonate levels in the normal range, and a minority (17% to 27%) had values just above 28 mEq/L. Only a small percentage (10% to 12%) of patients in either the CAPD or the APD groups had a serum HCO3 less than 22 mEq/L, an indication of the successful correction of acidosis in most patients. The anion gap was elevated (> 16 mEq/L) in the majority of patients on CAPD and APD and bore an inverse relationship to serum HCO3 and a direct relationship to serum albumin and serum phosphate. In CAPD patients, but not APD patients, a significant inverse relationship was observed between the anion gap and peritoneal permeability as assessed by four-hour D/P(creatinine). The correction of acidosis in PD appears to be predominantly achieved by the continuous supplementation of alkali via dialysis, with residual renal function not differentiating the degree of correction. Steady-state serum bicarbonate in patients on CAPD appeared to be responsive to the underlying peritoneal membrane permeability characteristics of the patient that govern alkali loss and gain, but the higher dialysate volumes in APD appear to override this effect. Higher albumin, blood urea nitrogen (BUN), and phosphate in patients with lower HCO3 suggest a discrepancy between daily acid load and dialysis dose.
Authors:
Salim Mujais
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  -     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-02-11     Completed Date:  2004-07-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S26-36     Citation Subset:  IM    
Affiliation:
Renal Division, Baxter Healthcare Corporation, McGaw Park, Illinois, USA.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium*
Acidosis / metabolism,  therapy
Automation
Bicarbonates / blood
Biological Transport
Female
Homeostasis
Humans
Kidney / physiopathology
Male
Middle Aged
Peritoneal Dialysis*
Peritoneal Dialysis, Continuous Ambulatory
Peritoneum / metabolism
Chemical
Reg. No./Substance:
0/Bicarbonates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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