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Kinetics of acid-base parameters in conventional hemodialysis

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 convention...

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Autores principales: Lugon, J.R., Pereira, G.R.M., Strogoff-de-Matos, J.P., Peixoto, A.J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação Brasileira de Divulgação Científica 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301264/
https://www.ncbi.nlm.nih.gov/pubmed/30539970
http://dx.doi.org/10.1590/1414-431X20187974
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author Lugon, J.R.
Pereira, G.R.M.
Strogoff-de-Matos, J.P.
Peixoto, A.J.
author_facet Lugon, J.R.
Pereira, G.R.M.
Strogoff-de-Matos, J.P.
Peixoto, A.J.
author_sort Lugon, J.R.
collection PubMed
description 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 pCO(2) 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 pCO(2) 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., pCO(2) elevation) was impaired.
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spelling pubmed-63012642019-01-11 Kinetics of acid-base parameters in conventional hemodialysis Lugon, J.R. Pereira, G.R.M. Strogoff-de-Matos, J.P. Peixoto, A.J. Braz J Med Biol Res Research Article 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 pCO(2) 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 pCO(2) 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., pCO(2) elevation) was impaired. Associação Brasileira de Divulgação Científica 2018-12-10 /pmc/articles/PMC6301264/ /pubmed/30539970 http://dx.doi.org/10.1590/1414-431X20187974 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Lugon, J.R.
Pereira, G.R.M.
Strogoff-de-Matos, J.P.
Peixoto, A.J.
Kinetics of acid-base parameters in conventional hemodialysis
title Kinetics of acid-base parameters in conventional hemodialysis
title_full Kinetics of acid-base parameters in conventional hemodialysis
title_fullStr Kinetics of acid-base parameters in conventional hemodialysis
title_full_unstemmed Kinetics of acid-base parameters in conventional hemodialysis
title_short Kinetics of acid-base parameters in conventional hemodialysis
title_sort kinetics of acid-base parameters in conventional hemodialysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301264/
https://www.ncbi.nlm.nih.gov/pubmed/30539970
http://dx.doi.org/10.1590/1414-431X20187974
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