Variability in monthly serum bicarbonate measures in hemodialysis patients

A cohort study

Ravi Patel, William Paredes, Charles B. Hall, Mark A. Nader, Deepak Sapkota, Vaughn Wesley Folkert, Matthew K. Abramowitz

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Some nephrologists have advocated an individualized approach to the prescription of bicarbonate hemodialysis. However, the utility of monthly serum bicarbonate levels for guiding and evaluating such treatment decisions has not been evaluated. We sought to define the variability of these measurements and to determine factors that are associated with month-to-month variability in pre-dialysis serum bicarbonate. Methods: We examined the monthly variability in serum bicarbonate measurements among 181 hemodialysis patients admitted to a free-standing dialysis unit in the Bronx, NY from 1/1/2008-6/30/2012. All patients were treated with a uniform bicarbonate dialysis prescription (bicarbonate 35 mEq/L, acetate 8 mEq/L). Pre-dialysis serum bicarbonate values were obtained from monthly laboratory reports. Month-to-month variability was defined using a rolling measurement for each time point. Results: Only 34 % of high serum bicarbonate values (>26 mEq/L) remained high in the subsequent month, whereas 60 % converted to normal (22-26 mEq/L). Of all low values (

Original languageEnglish (US)
JournalBMC Nephrology
DOIs
StateAccepted/In press - Dec 21 2015

Fingerprint

Bicarbonates
Renal Dialysis
Cohort Studies
Serum
Dialysis
Prescriptions
Acetates

Keywords

  • Acidosis
  • Alkalosis
  • Bicarbonate
  • End-stage renal disease
  • Hemodialysis
  • Variability

ASJC Scopus subject areas

  • Nephrology

Cite this

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title = "Variability in monthly serum bicarbonate measures in hemodialysis patients: A cohort study",
abstract = "Background: Some nephrologists have advocated an individualized approach to the prescription of bicarbonate hemodialysis. However, the utility of monthly serum bicarbonate levels for guiding and evaluating such treatment decisions has not been evaluated. We sought to define the variability of these measurements and to determine factors that are associated with month-to-month variability in pre-dialysis serum bicarbonate. Methods: We examined the monthly variability in serum bicarbonate measurements among 181 hemodialysis patients admitted to a free-standing dialysis unit in the Bronx, NY from 1/1/2008-6/30/2012. All patients were treated with a uniform bicarbonate dialysis prescription (bicarbonate 35 mEq/L, acetate 8 mEq/L). Pre-dialysis serum bicarbonate values were obtained from monthly laboratory reports. Month-to-month variability was defined using a rolling measurement for each time point. Results: Only 34 {\%} of high serum bicarbonate values (>26 mEq/L) remained high in the subsequent month, whereas 60 {\%} converted to normal (22-26 mEq/L). Of all low values (",
keywords = "Acidosis, Alkalosis, Bicarbonate, End-stage renal disease, Hemodialysis, Variability",
author = "Ravi Patel and William Paredes and Hall, {Charles B.} and Nader, {Mark A.} and Deepak Sapkota and Folkert, {Vaughn Wesley} and Abramowitz, {Matthew K.}",
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T1 - Variability in monthly serum bicarbonate measures in hemodialysis patients

T2 - A cohort study

AU - Patel, Ravi

AU - Paredes, William

AU - Hall, Charles B.

AU - Nader, Mark A.

AU - Sapkota, Deepak

AU - Folkert, Vaughn Wesley

AU - Abramowitz, Matthew K.

PY - 2015/12/21

Y1 - 2015/12/21

N2 - Background: Some nephrologists have advocated an individualized approach to the prescription of bicarbonate hemodialysis. However, the utility of monthly serum bicarbonate levels for guiding and evaluating such treatment decisions has not been evaluated. We sought to define the variability of these measurements and to determine factors that are associated with month-to-month variability in pre-dialysis serum bicarbonate. Methods: We examined the monthly variability in serum bicarbonate measurements among 181 hemodialysis patients admitted to a free-standing dialysis unit in the Bronx, NY from 1/1/2008-6/30/2012. All patients were treated with a uniform bicarbonate dialysis prescription (bicarbonate 35 mEq/L, acetate 8 mEq/L). Pre-dialysis serum bicarbonate values were obtained from monthly laboratory reports. Month-to-month variability was defined using a rolling measurement for each time point. Results: Only 34 % of high serum bicarbonate values (>26 mEq/L) remained high in the subsequent month, whereas 60 % converted to normal (22-26 mEq/L). Of all low values (

AB - Background: Some nephrologists have advocated an individualized approach to the prescription of bicarbonate hemodialysis. However, the utility of monthly serum bicarbonate levels for guiding and evaluating such treatment decisions has not been evaluated. We sought to define the variability of these measurements and to determine factors that are associated with month-to-month variability in pre-dialysis serum bicarbonate. Methods: We examined the monthly variability in serum bicarbonate measurements among 181 hemodialysis patients admitted to a free-standing dialysis unit in the Bronx, NY from 1/1/2008-6/30/2012. All patients were treated with a uniform bicarbonate dialysis prescription (bicarbonate 35 mEq/L, acetate 8 mEq/L). Pre-dialysis serum bicarbonate values were obtained from monthly laboratory reports. Month-to-month variability was defined using a rolling measurement for each time point. Results: Only 34 % of high serum bicarbonate values (>26 mEq/L) remained high in the subsequent month, whereas 60 % converted to normal (22-26 mEq/L). Of all low values (

KW - Acidosis

KW - Alkalosis

KW - Bicarbonate

KW - End-stage renal disease

KW - Hemodialysis

KW - Variability

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