ORIGINAL ARTICLE

Effect of dialysate bicarbonate and sodium on blood pH in maintenance hemodialysis—A prospective study

Corresponding Author

Nagaraja Rao Sridhar

[email protected]

orcid.org/0000-0001-8412-7604

Department of Nephrology, Buffalo Medical Group, Buffalo, New York, USA

Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA

Correspondence

Nagaraja Rao Sridhar, Department of Nephrology, Buffalo Medical Group, Buffalo, New York, USA and Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

Email: [email protected]

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Ziqiang Chen,

Ziqiang Chen

School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA

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Guan Yu,

Guan Yu

School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA

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Judy Lambert,

Judy Lambert

Regional Center of Excellence in Transplantation and Kidney Care, Nursing Department, Outpatient Hemodialysis Unit, Erie County Medical Center, Buffalo, New York, USA

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Mary Muscarella,

Mary Muscarella

Regional Center of Excellence in Transplantation and Kidney Care, Nursing Department, Outpatient Hemodialysis Unit, Erie County Medical Center, Buffalo, New York, USA

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Madan Nanjundegowda,

Madan Nanjundegowda

Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA

Regional Center of Excellence in Transplantation and Kidney Care, Erie County Medical Center, Buffalo, New York, USA

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Mandip Panesar,

Mandip Panesar

Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA

Regional Center of Excellence in Transplantation and Kidney Care, Erie County Medical Center, Buffalo, New York, USA

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Nagaraja Rao Sridhar,

Corresponding Author

Nagaraja Rao Sridhar

[email protected]

orcid.org/0000-0001-8412-7604

Department of Nephrology, Buffalo Medical Group, Buffalo, New York, USA

Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA

Correspondence

Email: [email protected]

Search for more papers by this author

Ziqiang Chen,

Ziqiang Chen

School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA

Search for more papers by this author

Guan Yu,

Guan Yu

School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA

Search for more papers by this author

Judy Lambert,

Judy Lambert

Regional Center of Excellence in Transplantation and Kidney Care, Nursing Department, Outpatient Hemodialysis Unit, Erie County Medical Center, Buffalo, New York, USA

Search for more papers by this author

Mary Muscarella,

Mary Muscarella

Regional Center of Excellence in Transplantation and Kidney Care, Nursing Department, Outpatient Hemodialysis Unit, Erie County Medical Center, Buffalo, New York, USA

Search for more papers by this author

Madan Nanjundegowda,

Madan Nanjundegowda

Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA

Regional Center of Excellence in Transplantation and Kidney Care, Erie County Medical Center, Buffalo, New York, USA

Search for more papers by this author

Mandip Panesar,

Mandip Panesar

Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA

Regional Center of Excellence in Transplantation and Kidney Care, Erie County Medical Center, Buffalo, New York, USA

Search for more papers by this author

First published: 17 August 2022

https://doi.org/10.1111/1744-9987.13920

Citations: 1

Funding information: Research Foundation for the State University of New York, Educational Grant to Dr. Mandip Panesar

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Abstract

Introduction

The validity of adjusting dialysate bicarbonate based on pre-hemodialysis (HD) serum bicarbonate is unclear. There are no studies of the impact of dialysate sodium on blood pH.

Aims

To understand the impact of dialysate bicarbonate and sodium on blood pH.

Methods

Two hundred arterialized blood samples were obtained on the third session of HD with four configurations of dialysate: sodium (140, 137 mEq/L) and bicarbonate (38, 32 mEq/L).

Results

The correlation between pre-HD serum bicarbonate and pH was modest (r = 0.6). A lower dialysate sodium (p = 0.035) and a higher bicarbonate (p = 0.02) associated with a higher post-HD blood pH. The frequency of pre-HD blood pH of <7.4 and a post-HD blood pH of >7.5 did not differ for samples with serum bicarbonate <22, 22–26, or >26 mEq/L.

Discussion/Conclusions

Adjusting dialysate buffer based on pre-HD serum bicarbonate is unnecessary. A higher bicarbonate and lower dialysate sodium associate with post-HD alkalemia.

CONFLICT OF INTEREST

The authors declare that there are no conflicts of interest for this article.

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Volume27, Issue2

April 2023

Pages 270-277

Effect of dialysate bicarbonate and sodium on blood pH in maintenance hemodialysis—A prospective study

Abstract

Introduction

Aims

Methods

Results

Discussion/Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Information

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Effect of dialysate bicarbonate and sodium on blood pH in maintenance hemodialysis—A prospective study

Abstract

Introduction

Aims

Methods

Results

Discussion/Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Related

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