Vztah mezi pH a diferencí silných iontů (SID) ve vnitřním prostředí u pacientů s chronickým ledvinným onemocněním v predialyzačním stadiu a při chronické dialýze

• Main Author: Havlín, Jan
• Other Authors: Matoušovic, Karel
• Format: Doctoral Thesis
• Language: Czech
• Published: 2015
• Online Access: http://www.nusl.cz/ntk/nusl-351034

SUMMARY: Metabolic acidosis (MAC) is a constant symptom of chronic kidney diesease (CKD) in advanced stages. The Siggaard-Andersen analysis is a traditional method of acid-base balance (ABB) assessment, assessing the metabolic component by means of the base excess and the anion gap (AG). Modern methods of ABB assessment draw upon the theory proposed by Stewart, which is based on the electric neutrality principle. Stewart distinguishes three independent variables determining plasmatic pH: pCO2, strong ion difference (SID) and 3) the total charge of non-volatile weak acids [Atot-]. The aim of this study was to assess the relationship between pH and plasma ion changes associated with ABB disorders in patients with chronic kidney disease using both methods of analysis, and subsequently compare both approaches. The cohort of patients consisted of three groups: 1) the "CKD" group, 60 patients with CKD stage 3 to 4 according to the KDOQI; 2) the "HD" group, 68 patients on chronic hemodiafiltration using dialysate bicarbonate concentration of 32 mmol/L; 3) a control group, 19 healthy volunteers. In all patients we measured parameters necessary for both approaches, in the HD group before and after dialysis treatment. We have found that MAC was present in two thirds of patients in the CKD group. A decrease of...