Abstract: SA-PO910
Metabolic and Volemic Evaluation in the Long Interdialytic Interval of Patients in Hemodialysis with and Without Residual Renal Function
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Almeida, Lenina L. S., Federal University of Cariri, Juazeiro do Norte, Brazil
- Sette, Luis H.B.C., Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- Oliveira, Francisco H., Federal University of Cariri, Juazeiro do Norte, Brazil
- Fonseca, Fernando Luiz affonso, Faculdade de Medicina do ABC, SAnto - André, Brazil
- Bergamo, Ronaldo Roberto, Faculdade de Medicina do ABC, SAnto - André, Brazil
- Bezerra, Leila S. V., Fmabc, Juazeiro do Norte, Brazil
Background
It is unclear whether residual renal function (RRF) in dialysis patients can attenuate the metabolic impact of the long 68-hour interdialytic interval, in which volume, acid and electrolyte accumulation occurs.
The aim of this study was to evaluate serum electrolyte levels, water balance and acid-base status in dialytic patients with and without RRF over the the long interdialytic interval (LII).
Methods
It was a unicentric, transversal and analytical study, which compared patients with and without RRF, defined by diuresis above 200 mL in 24 hours. Patients were weighed and subjected to the collection of serum samples for biochemical and gasometric analysis after the last hemodialysis (HD) of the week and before the first session of the subsequent week.
Results
We evaluated 24 and 27 patients with and without RRF, respectively. The mean urea and creatinine clearance was 3.6 ± 2.12 mL/min/1.73 m2 in the RRF group. Patients without RRF had a higher increase of serum potassium during the LII (2.67 x 1.14 mEq/L,p<0.001) reaching higher values at the end of the study (6.8 x 5.72 mEq/L,p< 0.001), as well as lower post-HD pH value (7.40 x 7.43, p=0.018) and tendency to lower pre-HD pH value (7.30 x 7.27, p=0.07) (table). In addition, at the end of the LII, they presented a higher proportion of patients with serum bicarbonate<18mEq/L (50 x 14.8%, p = 0.007),mixed acid-base disorder (57.7 x 29.2%,p=0.042), higher interdialytic weight gain (14.67 x 8.87 mL/kg/h,p<0.001) and lower natremia (137 x 139 mEq/L,p=0.02). Serum calcium and phosphorus levels, as well as blood pressure, were not different between groups.
Conclusion
Patients with RRF had better control of serum potassium, sodium, acid-base status, and volemia throughout the LII.
Variation of electrolytes and acid-base status over the LII acordding to RRF
| Variable | With residual renal function N=27 | Without residual renal function N=24 | p † |
| Potassium (meq/L) post- HD Mean Variation pre –HD | ---- 4.48 ± 0.76 1.14 ± 1.26 5.72 ± 0.96 | ---- 4.12 ± 0.67 2.67 ± 1.23 6.8 ± 0.67 | ---- 0.08 < 0.001* < 0.001* |
| Sodium (mEq/L) post- HD Mean Variation pre –HD | ---- 139.03 ± 5.14 0.00 ± 4.14 139.03 ± 3.00 | ---- 137.87 ±2.99 - 0.79 ± 5.05 137.08± 2.78 | ---- 0.337 0.542 0.020* |
| Phosphate (mg/dl) post- HD Mean variation pre –HD | ---- 3.73 ± 0.84 1.24 ± 1.61 4.98 ± 1.54 | ---- 4.43 ± 1.69 1.12 ± 1.62 5.55 ± 1.90 | ---- 0.064 0.784 0.241 |
| Calcium (mg/dL) post- HD Mean variation pre –HD | ---- 10.79 ± 1.01 -2.11 ± 0.95 8.68 ± 0.54 | ---- 10.79 ± 1.01 -2.11 ± 0.95 8.68 ± 0.54 | ---- 0.927 0.683 0.640 |
| pH post- HD Mean variation pre-HD | ---- 7.43 ± 0.47 -0.12 ± 0.05 7.30 ± 0.05 | ---- 7.40 ± 0.04 -0.12 ± 0.08 7.27 ± 0.06 | ---- 0.018 * 0.940 0.073 |
| Bicarbonate (mEq/L) post- HD Mean Variation pre-HD | ---- 26.62 ± 2.50 -6.71 ± 3.52 19.91 ± 2.85 | ---- 26.00 ± 2.40 - 6.76 ± 3.48 19.24 ± 2.84 | ---- 0.372 0.959 0.403 |
| pCO2 post- HD Mean Variation pre-HD | ---- 39.80 ± 3.99 - 0.60 ±4.08 39.19 ± 6.24 | ---- 41.93 ± 5.47 -0.88 ± 4.70 41.04 ± 4.02 | ---- 0.116 0.821 0.221 |
†= independent samples t-test, * = p< 0,05