Hyperchloraemia: A Non-Specific Finding in Chronic Renal Failure

Enia, Giuseppe; Catalano, Carlo; Zoccali, Carmine; Maggiore, Q; Poon, Teresa; Ward, M. K.; Kerr, David

doi:10.1159/000183579

Cited by 9 publications

(2 citation statements)

References 3 publications

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“…Hyperchloremic metabolic acidosis is observed in 30% to 50% of patients with chronic renal failure [21]. The chloride concentration in serum has been reported to increase as HCO 3 − concentration in serum decreases [22].…”

Section: Discussionmentioning

confidence: 99%

Approximation of bicarbonate concentration using serum total carbon dioxide concentration in patients with non-dialysis chronic kidney disease

Hirai

Minato

Kaneko

et al. 2019

Kidney Res Clin Pract.

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Background We investigated the relationship between serum total carbon dioxide (CO 2 ) and bicarbonate ion (HCO 3 − ) concentrations in pre-dialysis chronic kidney disease (CKD) patients and devised a formula for predicting low bicarbonate (HCO 3 − < 24 mmol/L) and high bicarbonate (HCO 3 − ≥ 24 mmol/L) using clinical parameters. Methods In total, 305 samples of venous blood collected from 207 pre-dialysis patients assessed by CKD stage (G1 + G2, 46; G3, 50; G4, 51; G5, 60) were investigated. The relationship between serum total CO 2 and HCO 3 − concentrations was analyzed using Pearson’s correlation coefficient. An approximation formula was developed using clinical parameters correlated independently with HCO 3 − concentration. Diagnostic accuracy of serum total CO 2 and the approximation formula was evaluated by receiver operating characteristic curve analysis and a 2 × 2 table. Results Serum total CO 2 correlated strongly with HCO 3 − concentration (r = 0.91; P < 0.001). The following approximation formula was obtained by a multiple linear regression analysis: HCO 3 − (mmol/L) = total CO 2 − 0.5 × albumin − 0.1 × chloride − 0.01 × (estimated glomerular filtration rate + blood glucose) + 15. The areas under the curves of serum total CO 2 and the approximation formula for detection of low bicarbonate and high bicarbonate were 0.981, 0.996, 0.993, and 1.000, respectively. This formula had superior diagnostic accuracy compared with that of serum total CO 2 (86.6% vs. 81.3%). Conclusion Serum total CO 2 correlated strongly with HCO 3 − concentration in pre-dialysis CKD patients. An approximation formula including serum total CO 2 showed superior diagnostic accuracy for low and high bicarbonate compared with serum total CO 2 .

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Section: Discussionmentioning

confidence: 99%

Approximation of bicarbonate concentration using serum total carbon dioxide concentration in patients with non-dialysis chronic kidney disease

Hirai

Minato

Kaneko

et al. 2019

Kidney Res Clin Pract.

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“…Metabolic acidosis occurs commonly in patients with CKD Ϫ in 56,386 MHD patients (unadjusted data). (3,4,38,39). Acidemia is believed to be an important cause of morbidity and many adverse consequences in patients with CKD and ESRD (2,5,38,40,41).…”

Section: Discussionmentioning

confidence: 99%

Association between serum bicarbonate and death in hemodialysis patients: Is it better to be acidotic or alkalotic?

Kilpatrick

Dadres

et al. 2005

Hemodialysis International

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The optimal acid base status for survival in maintenance hemo‐dialysis (MHD) patients (pts) remains controversial. According to some reports acidosis is associated with improved survival in MHD pts, i.e., reverse epidemiology. We examined associations between baseline (first 3‐month averaged) serum bicarbonate (HCO3), divided into 12 categories, and 2‐yr mortality in 56,376 MHD pts across the US after controlling for confounding effects of malnutrition‐inflammation complex syndrome (MICS). Three sets of Cox regression models were evaluated to estimate hazard ratios (HR) of death and 95% confidence intervals (CI): (1) Unadjusted; (2) Multivariate adjusted for case‐mix (age, gender, diabetes, race, insurance, marital status, vintage, standardized mortality ratio, residual renal function, dialysate HCO3, and Kt/V); and (3) Additional adjustments for 8 markers of MICS (body mass index, serum albumin, creatinine, ferritin, TIBC, dietary protein intake, WBC and lymphocyte counts). See Figure for HR and 95% CI: We conclude that, although high HCO3 levels appear to be associated with increased mortality in MHD pts, this paradoxical effect is almost entirely due to the overwhelming impact of MICS on survival.

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Acute and Chronic Renal Failure

Johnson¹

1992

Applied Therapeutics

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THERE are five books in this series, each dealing with a single topic or related group of topics. They seem a little expensive for their size at £5.95 each, but they have hard covers and are pleasantly produced on good quality paper. Taken together they cover renal disease in sufficient detail for anyone except the specialist nephrologist. They certainly would be adequate for preparation for the membership examination, and would be very helpful for a registrar coming to work in a renal unit. They are, however, somewhat uneven in quality. Renal Glomerular

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Hyperchloraemia: A Non-Specific Finding in Chronic Renal Failure

Cited by 9 publications

References 3 publications

Approximation of bicarbonate concentration using serum total carbon dioxide concentration in patients with non-dialysis chronic kidney disease

Approximation of bicarbonate concentration using serum total carbon dioxide concentration in patients with non-dialysis chronic kidney disease

Association between serum bicarbonate and death in hemodialysis patients: Is it better to be acidotic or alkalotic?

Acute and Chronic Renal Failure

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