Acid Base and Divalent Cation and Anion Abnormalities in Prevalent Maintenance Haemodialysis and CAPD Patients- Correlation with Clinical Parameters

Abstract

Acid base and divalent anion and cation abnormalities are quite common in dialysis patients and are associated with adverse outcomes. There is paucity of Indian data on the status of acid base and divalent ion balance of maintenance haemodialysis (MHD) and continuous ambulatory peritoneal dialysis (CAPD) patients. 94 patients (56 MHDl38 CAPD) were selected from Madras Medical Mission Hospital, Chennai. Clinical, biochemical and echocardiographic measurements were made to assess the acid base and divalent ion status of the patients and compared. Serum phosphate and albumin levels were higher in MHD patients (p=0.044; p<0.001 respectively). Corrected serum calcium was higher in CAPD patients (p=0.025). The number of patients receiving bicarbonate supplements were 15 in MHD and 2 in CAPD (p=0.008). The mean bicarbonate level, which was the average of 3 measurements taken during the year, at 4 month intervals was significantly higher in CAPD patients, compared to MHD patients (p<0.001). In our study, we found that our CAPD patients are less acidotic, have higher calcium and lower phosphate levels compared to MHD patients. Whether these results will translate into increased survival in CAPD patients can be determined using future longitudinal multicentric studies