Retrospective study of acid-base disturbances in patients with chronic kidney disease

Abstract

Background. Impaired kidney function has a negative effect on the body’s acid-base status (ABS). However, a violation of ABS can worsen the course of chronic kidney disease (CKD). Therefore, during the examination and treatment of patients with CKD, it is necessary to take into account the ABS. The purpose of the study: to conduct a retrospective analysis of the dynamics of ABS indicators in patients with stage 1–5 CKD who sought outpatient medical care in a medical institution in Kyiv. Materials and methods. A retrospective, randomized, cohort study was performed of 53 medical records of patients (form 025/o) who sought outpatient medical care at the Professor Dmytro Ivanov Nephrological Clinic LLC with a diagnosis of stage 1–5 CKD from February 2022 to February 2023. Participants were examined for ABS indicators three times. They were divided into 2 groups: group 1 (n = 31) — stage 1–3 CKD and group 2 (n = 22) — stage 4–5 CKD. An analysis of ABS indicators was carried out in dyna­mics. Results. Results of multiple linear regression for patients with stage 1–5 CKD (n = 53) showed that there was a strong significant effect between potassium (K+) and glomerular filtration rate (GFR) (F(1, 13) = 10.59, p = 0.006, R2 = 0.45, R2 adj = 0.41). The results of multiple linear regression of indicators in patients with stage 1–3 CKD (group 1) demonstrated a weak insignificant influence between lactate and GFR (F(1, 15) = 1.11, p = 0.310, R2 = 0.07, R2 adj = 0.01). The results of multiple linear regression of indicators in patients with stage 4–5 CKD (group 2) showed that there is a very strong combined insignificant influence between the hydrogen index, partial pressure of carbon dioxide, partial pressure of oxygen, bicarbonate concentration, base excess of extracellular fluid, K+, total carbon dioxide, anion gap with K concentration included in the equation, base excess, lactate and GFR (F(10, –3) = 0.3, p = 58.099, R2 = –65.23, R2 adj = 155.53). Conclusions. When studying ABS in patients with stage 1–5 CKD, a correlation was found between K+ and GFR using the multiple linear regression tool. In the first group, the relationship between lactate and GFR, in the second one, all predictors had a relationship with GFR.