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Chinese Journal of Blood Purification ›› 2003, Vol. 2 ›› Issue (5) : 253-256.

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Abstract

Objective To get the information of occurrence rate of metabolic acidosis（MA）in maintenance hemodialysis（MHD）and to investigate the impact of MA on nutritional status. Methods Eighty-nine MHD patients were enrolled in the study. Predialysis laboratory values including HCO3-, urea nitrogen, creatinine, albumin, prealbumin, calcium, phosphorus and intact parathyroid hormone (PTH) were checked. Kt／V,total lymphocyte counts（TLC）and normalized protein catabolic rate (nPCR) were calculated. The correlations between predialysis serum HCO3- level and parameters related to dietary intake and nutritional status were analyzed. MA was defined as a predialysis serum HCO3- concentration of ≤21mmol/L. The subjects were divided into 2 groups: one (MA group) consisted of 61 cases who had a mean serum HCO3- levels equal to or less than 21mmol/L, the other (non-MA group) consisted of 28 cases whose mean serum HCO3- concentrations were more than 21mmol/L. Results The predialysis serum HCO3- concentrations were 19.26±3.51 mmol/L in 89 cases, of which the occurrence rate of MA was 68.5%. The predialysis serum HCO3- level correlated positively with serum calcium，negatively with serum phosphorus, urea nitrogen, creatinine, uric acid, albumin, prealbumin and nPCR (P＜0.05), while there were no significant correlations between predialysis serum HCO3- level and BMI, TLC, Kt／V and PTH（ P＞0.05）. Urea nitrogen, creatinine, albumin, prealbumin and nPCR were significantly different between the MA group and the non-MA group（ P＜0.05）, whereas BMI,TLC, Kt／V, calcium, phosphorus and PTH levels showed no statistically significant differences （P＞0.05）. Conclusion Mild predialysis MA is very common even in well-dialyzed MHD patients，which may be the result of increased protein intake rather than the cause of the high protein catabolic rate. Moreover, the degree of MA may not influence nutritional parameters in a short time, but the further investigation as to long-term effect of MA on the nutritional status should be made.