Dose-related effects of metformin on acid–base balance and renal function in patients with diabetes who develop acute renal failure: a cross-sectional study

2016 ◽  
Vol 53 (4) ◽  
pp. 551-558 ◽  
Author(s):  
David Cucchiari ◽  
Manuel Alfredo Podestà ◽  
Elisa Merizzoli ◽  
Albania Calvetta ◽  
Emanuela Morenghi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acid Base Balance ◽  
Acid Base ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Base Balance

Impact of Continuous Veno-venous Hemofiltration on Acid-base Balance

2003 ◽  
Vol 26 (1) ◽  
pp. 19-25 ◽  
Author(s):  
J. Rocktäschel ◽  
H. Morimatsu ◽  
S. Uchino ◽  
C. Ronco ◽  
R. Bellomo
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Metabolic Alkalosis ◽  
Base Excess ◽  
Strong Ion Difference ◽  
Acid Base Balance ◽  
Strong Ion Gap ◽  
Acid Base ◽  
Biophysical Analysis ◽  
Base Balance

Background Continuous veno-venous hemofiltration (CVVH) appears to have a significant and variable impact on acid-base balance. However, the pathogenesis of these acid-base effects remains poorly understood. The aim of this study was to understand the nature of acid-base changes in critically ill patients with acute renal failure during continuous veno-venous hemofiltration by applying quantitative methods of biophysical analysis (Stewart-Figge methodology). Methods We studied forty patients with ARF receiving CVVH in the intensive care unit. We retrieved the biochemical data from computerized records and conducted quantitative biophysical analysis. We measured serum Na+, K+, Mg2+, Cl-, HCO3-, phosphate, ionized Ca2+, albumin, lactate and arterial blood gases and calculated the following Stewart-Figge variables: Strong Ion Difference apparent (SIDa), Strong Ion Difference Effective (SIDe) and Strong Ion Gap (SIG). Results Before treatment, patients had mild acidemia (pH: 7.31) secondary to metabolic acidosis (bicarbonate: 19.8 mmol/L and base excess: −5.9 mEq/L). This acidosis was due to increased unmeasured anions (SIG: 12.3 mEq/L), hyperphosphatemia (1.86 mmol/L) and hyperlactatemia (2.08 mmol/L). It was attenuated by the alkalinizing effect of hypoalbuminemia (22.5 g/L). After commencing CVVH, the acidemia was corrected within 24 hours (pH 7.31 vs 7.41, p <0.0001). This correction was associated with a decreased strong ion gap (SIG) (12.3 vs. 8.8 mEq/L, p <0.0001), phosphate concentration (1.86 vs. 1.49 mmol/L, p <0.0001) and serum chloride concentration (102 vs. 98.5 mmol/L, p <0.0001). After 3 days of CVVH, however, patients developed alkalemia (pH: 7.46) secondary to metabolic alkalosis (bicarbonate: 29.8 mmol/L, base excess: 6.7 mEq/L). This alkalemia appeared secondary to a further decrease in SIG to 6.7 mEq/L (p <0.0001) and a further decrease in serum phosphate to 0.77 mmol/L (p <0.0001) in the setting of persistent hypoalbuminemia (21.0 g/L; p=0.56). Conclusions CVVH corrects metabolic acidosis in acute renal failure patients through its effect on unmeasured anions, phosphate and chloride. Such correction coupled with the effect of hypoalbuminemia, results in the development of a metabolic alkalosis after 72 hours of treatment.

scholarly journals Healthy adult vegetarians have better renal function than matched omnivores: a cross-sectional study in China

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaijie Xu ◽  
Xueying Cui ◽  
Bian Wang ◽  
Qingya Tang ◽  
Jianfang Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Healthy Adult ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional
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