Continuous pH and HCO3 monitoring during hemodiafiltration without blood sampling. 1991

P M Ghezzi, and R Gervasio, and J Botella
Nephrology Department, S. Croce Hospital, Cuneo, Italy.

The correction of acid-base balance during hemodialysis, especially in high-efficiency techniques, could present some problem related to the lack of an adequate monitoring of pH and blood gases. During hemodiafiltration (HDF), performed with the two-chamber technique (paired filtration dialysis, PFD), the ultrafiltrate (Uf) is continuously available, unmixed with the dialysate. Connecting a pH electrode (as Ag/C1Ag) to the Uf circuit, the authors made 40 determinations on 16 different PFD patients, and they correlated the Uf values obtained with those measured on arterial blood with standard methods. The one sample analysis gave a t = 10.145 (p = 0.0), and the linear regression analysis an r = 0.931 (p = 0.0). At 30 min, in 8 PFD patients, the HCO3 values obtained from Uf, pH and transcutaneous PCO2, gave a t = 6.37 (p = 0.0004), and an r = 0.939 (p = 0.00052). In conclusion, during HDF performed with PFD, continuous pH monitoring of the patient is possible without blood sampling. Moreover, correlation with the transcutaneous PCO2 measurement could provide HCO3 values in real time.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006440 Hemofiltration Extracorporeal ULTRAFILTRATION technique without HEMODIALYSIS for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. Arteriovenous Hemofiltration,Venovenous Hemofiltration,Arteriovenous Hemofiltrations,Hemofiltration, Arteriovenous,Hemofiltration, Venovenous,Hemofiltrations,Venovenous Hemofiltrations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations
D000136 Acid-Base Equilibrium The balance between acids and bases in the BODY FLUIDS. The pH (HYDROGEN-ION CONCENTRATION) of the arterial BLOOD provides an index for the total body acid-base balance. Anion Gap,Acid-Base Balance,Acid Base Balance,Acid Base Equilibrium,Anion Gaps,Balance, Acid-Base,Equilibrium, Acid-Base,Gap, Anion,Gaps, Anion
D000137 Acid-Base Imbalance Disturbances in the ACID-BASE EQUILIBRIUM of the body. Acid Base Imbalance,Acid-Base Imbalances,Imbalance, Acid-Base,Imbalances, Acid-Base
D001639 Bicarbonates Inorganic salts that contain the -HCO3 radical. They are an important factor in determining the pH of the blood and the concentration of bicarbonate ions is regulated by the kidney. Levels in the blood are an index of the alkali reserve or buffering capacity. Bicarbonate,Bicarbonate Ions,Hydrogen Carbonates,Bicarbonate Ion,Carbonic Acid Ions,Hydrogen Carbonate,Carbonate, Hydrogen,Carbonates, Hydrogen,Ion, Bicarbonate,Ions, Bicarbonate,Ions, Carbonic Acid

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