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2016 ; 4
(4
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Association between Low Serum Bicarbonate Concentrations and Cardiovascular
Disease in Patients in the End-Stage of Renal Disease
#MMPMID28933414
Raikou VD
; Kyriaki D
Diseases
2016[Nov]; 4
(4
): ä PMID28933414
show ga
BACKGROUND: Metabolic acidosis, a common condition particularly in the end-stage
of renal disease patients, results in malnutrition, inflammation and oxidative
stress. In this study, we focused on the association between low serum
bicarbonate and cardiovascular disease in patients on intermittent dialysis.
METHODS: We studied 52 on-line-pre-dilution hemodiafiltration (on-l HDF)
patients, 32 males and 20 females, with a mean age of 58.01 ± 15.4 years old.
Metabolic acidosis was determined by serum bicarbonate concentrations less than
22 mmol/L. Residual renal function (RRF) was defined by interdialytic urine
volume. Kaplan-Meier curves and Cox regression models were performed to predict
coronary artery disease (CAD), defined by ejection fraction <50%, or diastolic
dysfunction congestive heart failure (CHF) and peripheral vascular disease (PVD).
RESULTS: Kaplan-Meier analyses showed that a lower or higher than 22 mmol/L serum
bicarbonate metabolic acidosis status was significantly associated with both PVD
and diastolic dysfunction (log-rank = 5.07, p = 0.02 and log-rank = 5.84, p =
0.01, respectively). A similar prevalence of serum bicarbonate on CAD or CHF by
low ejection fraction was not shown. The RRF was associated with PVD event and
serum bicarbonate less than 22 mmol/L (log-rank = 5.49, p = 0.01 and log-rank =
3.9, p = 0.04, respectively). Cox regression analysis revealed that serum
bicarbonate and RRF were significant risk factors for PVD after adjustment for
confounders. Furthermore, RRF adjusted for covariates was shown to be a
significant risk factor for diastolic dysfunction. CONCLUSION: Low serum
bicarbonate was associated with peripheral vascular disease and diastolic
dysfunction in intermittent dialysis. The residual renal function may impact
patients' outcomes through its relationship with metabolic acidosis status,
particularly for peripheral vascular disease manifestation.