Total Carbon Dioxide Versus pH for Determining Acid-Base Status in Patients on Continuous Kidney Replacement Therapy: A Cohort Study

Woodell, Tyler B.; Webster, Luke; Mehta, Ravindra L.; Macedo, Etienne; Rifkin, Dena E.

doi:10.1053/j.ajkd.2020.06.015

Cited by 3 publications

(1 citation statement)

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“…Therefore, the time from phlebotomy to analysis is potentially longer for tCO 2 and with longer uncapping time but is cheaper and less prone to human errors. Unfortunately, studies comparing tCO 2 and HCO 3 – (P,st) has shown conflicting results, 3,7,8 and whether these two analyses can be used interchangeably is therefore questionable. The purpose of this study was to compare venous tCO 2 and venous HCO 3 – (P,st) from a broad spectrum of patients to determine, whether venous tCO 2 can substitute venous HCO 3 – (P,st) in a hospital setting for workup of acid–base disorders.…”

Section: Introductionmentioning

confidence: 99%

Comparison of plasma total carbon dioxide and standard hydrogen carbonate in a hospital laboratory setting

et al. 2023

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Background: Studies comparing venous total carbon dioxide (tCO2) and standard hydrogen carbonate (HCO3–(P,st)) has shown diverse results, and it is debatable whether these two parameters can be used interchangeably for workup of acid-base disorders in a hospital setting. Method: All patients with an HCO3–(P,st) requisition from any department at Odense University Hospital between 11th May 2021 and 1st June 2021 had tCO2 and HCO3–(P,st) analysed simultaneously. TCO2 was measured on Cobas® 8000, c702 module, while HCO3–(P,st) was calculated based on measurements on ABL835 Flex. Results: From 1210 patients, mean (standard deviation (SD)) was 22.9 (3.7) mmol/L for tCO2 and 22.5 (2.9) mmol/L for HCO3–(P,st). TCO2 range was 10.1-42.3 mmol/L and 11.7-41.4 mmol/L for HCO3–(P,st). Linear regression showed that tCO2 (mmol/L) = -2.90 + 1.15 x HCO3–(P,st) (mmol/L) with R2=0.81. Bias (mean (SD) difference) between tCO2 and HCO3–(P,st) was 0.4 (1.7) mmol/L with a -5.0-9.6 mmol/L range. Limits of agreement was -2.90 to 3.70 mmol/L. Comparison of classification within, above or below reference interval for tCO2 and HCO3–(P,st) showed that 984 samples (81%) retained their classification. Only one sample (0.1%) would be severely misclassified (outside the respective reference intervals) if HCO3–(P,st) was considered the gold standard. Of the samples investigated, 46.1% had a mean difference between tCO2 and HCO3–(P,st) of 0-1 mmol/L and 30.3% had 1.1-2.0 mmol/L. Conclusions: Our results indicate that venous tCO2 and venous HCO3–(P,st) can be used interchangeably in a hospital setting for workup of acid-base disorders.

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Section: Introductionmentioning

confidence: 99%

Comparison of plasma total carbon dioxide and standard hydrogen carbonate in a hospital laboratory setting

et al. 2023

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Modeling acid-base transport in hemodialyzers

Pietribiasi

Leypoldt

2021

Biocybernetics and Biomedical Engineering

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Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic

Yoo

Kim

et al. 2021

Sci Rep

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Large-scale studies have not been conducted to assess whether serum hypobicarbonatemia increases the risk for kidney function deterioration and mortality among East-Asians. We aimed to determine the association between serum total CO2 (TCO2) concentrations measured at the first outpatient visit and clinical outcomes. In this multicenter cohort study, a total of 42,231 adult nephrology outpatients from 2001 to 2016 were included. End-stage renal disease (ESRD) patients on dialysis within 3 months of the first visit were excluded. Instrumental variable (IV) was used to define regions based on the proportion of patients with serum TCO2 < 22 mEq/L. The crude mortality rate was 12.2% during a median 77.0-month follow-up period. The Cox-proportional hazard regression model adjusted for initial kidney function, alkali supplementation, and the use of diuretics demonstrated that low TCO2 concentration was not associated with progression to ESRD, but significantly increased the risk of death. The IV analysis also confirmed a significant association between initial TCO2 concentration and mortality (HR 0.56; 95% CI 0.49–0.64). This result was consistently significant regardless of the underlying renal function. In conclusion, low TCO2 levels are significantly associated with mortality but not with progression to ESRD in patients with ambulatory care.

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Total Carbon Dioxide Versus pH for Determining Acid-Base Status in Patients on Continuous Kidney Replacement Therapy: A Cohort Study

Cited by 3 publications

References 5 publications

Comparison of plasma total carbon dioxide and standard hydrogen carbonate in a hospital laboratory setting

Comparison of plasma total carbon dioxide and standard hydrogen carbonate in a hospital laboratory setting

Modeling acid-base transport in hemodialyzers

Low serum total CO2 and its association with mortality in patients being followed up in the nephrology outpatients clinic

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