Effect of dialysate bicarbonate and sodium on blood pH in maintenance hemodialysis—A prospective study.

Sridhar, Nagaraja Rao; Chen, Ziqiang; Yu, Guan; Lambert, Judy; Muscarella, Mary; Nanjundegowda, Madan; Panesar, Mandip

Introduction: The validity of adjusting dialysate bicarbonate based on pre‐hemodialysis (HD) serum bicarbonate is unclear. There are no studies of the impact of dialysate sodium on blood pH. Aims: To understand the impact of dialysate bicarbonate and sodium on blood pH. Methods: Two hundred arterialized blood samples were obtained on the third session of HD with four configurations of dialysate: sodium (140, 137 mEq/L) and bicarbonate (38, 32 mEq/L). Results: The correlation between pre‐HD serum bicarbonate and pH was modest (r = 0.6). A lower dialysate sodium (p = 0.035) and a higher bicarbonate (p = 0.02) associated with a higher post‐HD blood pH. The frequency of pre‐HD blood pH of 7.5 did not differ for samples with serum bicarbonate 26 mEq/L. Discussion/Conclusions: Adjusting dialysate buffer based on pre‐HD serum bicarbonate is unnecessary. A higher bicarbonate and lower dialysate sodium associate with post‐HD alkalemia.

SODIUM bicarbonate; BICARBONATE ions; LONGITUDINAL method; BLOOD sampling; SODIUM

Therapeutic Apheresis & Dialysis, 2023, Vol 27, Issue 2, p270

1744-9979

Academic Journal

10.1111/1744-9987.13920