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      Hemoglobin Level Is an Important Determinant of Acid-Base Status in Hemodialysis Patients

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      Nephron

      S. Karger AG

      Hemodialysis, Hemoglobin, Metabolic acidosis, Renal failure

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          Abstract

          Background/Aims: We studied the relationship between hemoglobin (Hb), which is a major buffer of blood, and arterial blood total carbon dioxide (tCO<sub>2</sub>) levels in maintenance hemodialysis (HD) patients. We also evaluated the difference between the tCO<sub>2</sub> measured with a standard Hb value of 15 g/dl, and that assayed with an actual Hb level entered into an analyzer. Methods/Results: In 105 patients the predialysis tCO<sub>2</sub> level of 21.4 ± 2.84 mEq/l inversely correlated with the Hb level of 9.5 ± 1.78 g/dl (r = –0.358, p = 0.0002). This indicated that the rise in Hb from 6 to 14 g/dl could result in a decrease of about 5 mEq/l in the tCO<sub>2</sub> level. In 20 patients the tCO<sub>2</sub> level measured at the Hb of 15 g/dl was 21.0 ± 2.47 mEq/l, and higher (p = 0.009) than that of 20.8 ± 2.45 mEq/l estimated at the actual Hb. The difference between these two measurements was inversely associated with the Hb level (r = –0.579, p = 0.007). The measurement of tCO<sub>2 </sub>at the unadjusted Hb slightly underestimated the degree of acidosis when the actual Hb level was < 11.5 g/dl. Conclusion: The degree of anemia and, to some extent, laboratory technique should always be considered when interpreting changes in arterial blood acid-base balance in maintenance HD patients.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          2002
          2002
          13 December 2001
          : 90
          : 1
          : 111-113
          Affiliations
          Department of Nephrology and Internal Medicine, Medical Academy, Białystok, Poland
          Article
          46324 Nephron 2002;90:111–113
          10.1159/000046324
          11744815
          © 2002 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 2, References: 6, Pages: 3
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/46324
          Categories
          Short Communication

          Cardiovascular Medicine, Nephrology

          Hemoglobin, Renal failure, Hemodialysis, Metabolic acidosis

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