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Acid‐base alterations in ESRD and effects of hemodialysis
Author(s) -
Qian Qi
Publication year - 2017
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12659
Subject(s) - medicine , hemodialysis , dialysis , kidney , hypoxia (environmental) , acid–base imbalance , hypercapnia , kidney disease , hypokalemia , cardiology , intensive care medicine , acidosis , chemistry , organic chemistry , oxygen
Acid‐base alterations in patients with kidney failure and on hemodialysis (HD) treatment contribute to (1) intradialytic hypercapnia and hypoxia, (2) hemodynamic instability and cardiac arrhythmia, (3) systemic inflammation, and (4) a number of associated electrolyte alterations including potentiating effects of hypokalemia, hypocalcemia and, chronically, soft‐tissue and vascular calcification, imparting poor prognosis and mortality. This paper discusses acid‐base regulation and pathogenesis of dysregulation in patients with kidney failure. Major organ and systemic effects of acid‐base perturbations with a specific focus on kidney failure patients on HD are emphasized, and potential mitigating strategies proposed. The high rate of HD‐related complications, specifically those that can be accounted for by rapid and steep acid‐base perturbations imposed by HD treatment, attests to the pressing need for investigations to establish a better dialysis regimen.