Abstract
Metabolic acidosis is highly prevalent in hemodialysis patients. The disorder is associated with increased mortality and its deleterious effects are already present in the predialysis phase of chronic kidney disease. Metabolic acidosis has been linked to progression of chronic kidney disease, changes in protein and glucose metabolism, bone and muscle disorders and cardiovascular disease. At present, the control of metabolic acidosis in hemodialysis is mainly focused on the supply of bicarbonate during dialysis session, but further studies are needed to set the optimum target serum bicarbonate and the best concentration of the bicarbonate dialysate. The present study reviews pathophysiological and epidemiological aspects of metabolic acidosis in hemodialysis patients and also addresses its adverse effects and treatment.
Highlights
End-stage renal disease (ESRD), which can be treated by either dialysis or transplantation, is a worldwide public health problem
Selected studies evaluating the impact of metabolic acidosis on mortality in dialysis patients
Chronic metabolic acidosis is closely related to chronic kidney disease and ESRD
Summary
End-stage renal disease (ESRD), which can be treated by either dialysis or transplantation, is a worldwide public health problem. National estimates of the rates of prevalence and incidence of dialysis were 499 and 170 patients per million people, respectively. The absolute number of dialysis patients has increased 3% annually over the past three years.[4]. The real extent of this problem in Brazil is unknown because, in 1996, the national regulatory agency for the dialysis procedure has published an ordinance in which the mandatory measurement of bicarbonate in patients on renal replacement. Selected studies evaluating the impact of metabolic acidosis on mortality in dialysis patients
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