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Provedor de dados:  BJMBR
País:  Brazil
Título:  Effect of chloride dialysate concentration on metabolic acidosis in aintenance hemodialysis patients
Autores:  Marques,F.O.
Libório,A.B.
Daher,E.F.
Data:  2010-10-01
Ano:  2010
Palavras-chave:  Chloride dialysate
Hemodialysis
Metabolic acidosis
Stewart model
Resumo:  Hyperchloremia is one of the multiple etiologies of metabolic acidosis in hemodialysis (HD) patients. The aim of the present study was to determine the influence of chloride dialysate on metabolic acidosis control in this population. We enrolled 30 patients in maintenance HD program with a standard base excess (SBE) ≤2 mEq/L and urine output of less than 100 mL/24 h. The patients underwent dialysis three times per week with a chloride dialysate concentration of 111 mEq/L for 4 weeks, and thereafter with a chloride dialysate concentration of 107 mEq/L for the next 4 weeks. Arterial blood was drawn immediately before the second dialysis session of the week at the end of each phase, and the Stewart physicochemical approach was applied. The strong ion gap (SIG) decreased (from 7.5 ± 2.0 to 6.2 ± 1.9 mEq/L, P = 0.006) and the standard base excess (SBE) increased after the use of 107 mEq/L chloride dialysate (from -6.64 ± 1.7 to -4.73 ± 1.9 mEq/L, P < 0.0001). ∆SBE was inversely correlated with ∆SIG during the phases of the study (Pearson r = -0.684, P < 0.0001) and there was no correlation with ∆chloride. When we applied the Stewart model, we demonstrated that the lower concentration of chloride dialysate interfered with the control of metabolic acidosis in HD patients, surprisingly, through the effect on unmeasured anions.
Tipo:  Info:eu-repo/semantics/article
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2010001000012
Editor:  Associação Brasileira de Divulgação Científica
Relação:  10.1590/S0100-879X2010007500094
Formato:  text/html
Fonte:  Brazilian Journal of Medical and Biological Research v.43 n.10 2010
Direitos:  info:eu-repo/semantics/openAccess
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