Evaluation of the expected ventilatory response to metabolic acidosis in chronic hemodialysis patients

Marano, Marco

doi:10.1111/hdi.12602

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Normalized protein nitrogen appearance (nPNA) was calculated by the formula: BUN / (36.3 + 5.48 × Kt/V + (53.5/Kt/V)) + 0.168, in which Kt/V was obtained by: –Ln (post BUN/pre BUN – 0.008 × t) + (4 – (3.5 × post BUN/pre BUN)) x UF/W (11). The respiratory response to metabolic acidosis and metabolic alkalosis were estimated by the formulas Expected pCO 2 = 1.2 × current HCO 3 - + 11.2 (12) and Expected pCO 2 = 40 + ((current HCO 3 – –24) × 0.7), respectively (13).…”

Section: Methodsmentioning

confidence: 99%

Kinetics of acid-base parameters in conventional hemodialysis

Lugon

Pereira

Strogoff-de-Matos

et al. 2019

Braz J Med Biol Res

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Details about the acid-base changes in hemodialysis are scarce in the literature but are potentially relevant to adequate management of patients. We addressed the acid-base kinetics during hemodialysis and throughout the interdialytic period in a cross-sectional study of adults undergoing conventional hemodialysis. Samples for blood gas analysis were obtained from the arterial limb of the arteriovenous fistula before the first session of the week (HD1), immediately at the end of HD1, and on sequential collections at 15, 30, 45, 60, and 120 min post-HD1. Additional blood samples were collected after ∼20 h following the end of the first dialysis and immediately prior to the initiation of the second dialysis of the week. Thirty adult patients were analyzed (55±15 years, 50% men, 23% diabetic; dialysis vintage 69±53 months). Mean serum bicarbonate levels increased at the end of HD1 (22.3±2.7 mEq/L vs 17.5±2.3 mEq/L, P<0.001) and remained stable until 20 h after the end of the session. The mean values of pCO2 before HD1 were below reference and at 60 and 120 min post-HD1 were significantly lower than at the start (31.3±2.7 mmHg and 30.9±3.7 mmHg vs 34.3±4.1 mmHg, P=0.041 and P=0.010, respectively). The only point of collection in which mean values of pCO2 were above 35 mmHg was 20 h post-dialysis. Serum bicarbonate levels remained stable for at least 20 h after the dialysis sessions, a finding that may have therapeutic implications. During dialysis, the respiratory response for correction of metabolic acidosis (i.e., pCO2 elevation) was impaired.

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Section: Methodsmentioning

confidence: 99%