Nephrology Dialysis Transplantation, Vol 13, Issue 7 1719-1722, Copyright © 1998 by Oxford University Press
E Movilli, R Zani, O Carli, L Sangalli, A Pola, C Camerini, G Cancarini, F Scolari, P Feller and R Maiorca
Background: Metabolic acidosis in haemodialysis (HD)
patients increases whole body protein degradation while the correction of
acidosis reduces it. However, the effects of the correction of acidosis on
nutrition have not been clearly demonstrated. Study
design: In this study we have evaluated the effects of 3 months
of correction of metabolic acidosis by oral sodium bicarbonate
supplementation on protein catabolic rate (PCRn) and serum albumin
concentrations in 12 uraemic patients on maintenance HD for at least 6
months (median 49 months; range 6-243 months). Pre-dialysis serum
bicarbonate, arterial pH, serum albumin, total serum proteins, serum
creatinine, plasma sodium, haemoglobin, PCRn, Kt/V, and TACurea, were
evaluated before and after correction. Results: Serum
bicarbonate levels and arterial pH increased respectively from
19.3±0.6 mmol/l to 24.4±1.2 mmol/l (P<0.0001)
and 7.34±0.03 to 7.40±0.02 (P<0.0001). Serum
albumin increased from 34.9±2.1 g/l to 37.9±2.9 g/l
(P<0.01) while PCRn decreased from 1.11±0.17 g/kg/day to
1.03±0.17 g/kg/day (P<0.001). No changes in Kt/V, total
serum proteins, serum creatinine, plasma sodium, haemoglobin, body weight,
pre dialysis systolic and diastolic blood pressure, and intradialytic
weight loss were observed. Conclusions: Our data
demonstrate that correction of metabolic acidosis improves serum albumin
concentration in HD patients. The correction of acidosis induced a decrease
in PCRn values, as evaluated by kinetic criteria, suggesting that in the
presence of moderate to severe acidosis this parameter does not reflect the
real dietary protein intake of the patients probably as a result of
increased catabolism of endogenous proteins. The correction of metabolic
acidosis should be considered of paramount importance in HD patients.
Key words: uraemia; acidosis; dialysis; nutrition;
PCRn; Kt/V; serum albumin
ORIGINAL ARTICLES
Correction of metabolic acidosis increases serum albumin concentrations and decreases kinetically evaluated protein intake in haemodialysis patients: a prospective study
Division of Nephrology, Spedali Civili, P le Ospedale Civile 1, 25123 Brescia, Italy; Corresponding author
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. G. Wann, Y.-H. Hsu, C.-C. Yang, C.-S. Lin, D. W. Tai, J.-S. Chen, C.-W. Hsiao, and C.-F. Chen Neutrophils in acidotic haemodialysed patients have lower intracellular pH and inflamed state Nephrol. Dial. Transplant., September 1, 2007; 22(9): 2613 - 2622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Wiederkehr, J. Kalogiros, and R. Krapf Correction of metabolic acidosis improves thyroid and growth hormone axes in haemodialysis patients Nephrol. Dial. Transplant., May 1, 2004; 19(5): 1190 - 1197. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-H. Lin, Y.-F. Lin, H.-M. Chin, and C.-C. Wu Must metabolic acidosis be associated with malnutrition in haemodialysed patients? Nephrol. Dial. Transplant., November 1, 2002; 17(11): 2006 - 2010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. E. Mitch Insights into the Abnormalities of Chronic Renal Disease Attributed to Malnutrition J. Am. Soc. Nephrol., January 1, 2002; 13(90001): S22 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. GIORDANO, P. D. FEO, P. LUCIDI, E. dePASCALE, G. GIORDANO, L. INFANTONE, A. M. ZOCCOLO, and P. CASTELLINO Increased Albumin and Fibrinogen Synthesis in Hemodialysis Patients with Normal Nutritional Status J. Am. Soc. Nephrol., February 1, 2001; 12(2): 349 - 354. [Abstract] [Full Text]
|
|