| [ Summary ] |
The acid-base status in hemodialysis patients has been assessed on the basis of total serum CO2 (or bicarbonate) concentration, but the optimum value of pre-dialysis bicarbonate is not clear. Our study revealed that pre-dialysis pH is a more reasonable marker than the bicarbonate, and patients with pH < 7.30 and ≥ 7.38 have a higher risk of all-cause mortality. Respiratory alkalosis occupies as much as one-third of patients with pH ≥ 7.38, and therefore caution should be employed in respiratory acid-base disorders. Pre-dialysis bicarbonate concentration is determined by dialysate bicarbonate concentration. Although the option of dialysate bicarbonate is limited in the central dialysate delivery system of our country, a lower concentration is more likely to be advantageous. The dialysate bicarbonate should be carefully selected after understanding the patient's condition by blood gas analysis. |