1. Hyperchloremic acidosis develops at the stage G4 and shifts to high anion gap acidosis at the stage G5 in chronic kidney disease
- Author
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Masayuki Tanemoto, Ryohei Kamachi, Takeshi Yokoyama, Yukio Okazaki, Seiki Yamada, and Takahide Kimura
- Subjects
Adult ,Male ,Nephrology ,medicine.medical_specialty ,Physiology ,Bicarbonate ,030232 urology & nephrology ,Urology ,Renal function ,030204 cardiovascular system & hematology ,Kidney ,urologic and male genital diseases ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Chlorides ,Physiology (medical) ,Internal medicine ,Hyperchloremic acidosis ,medicine ,Humans ,Serum chloride ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies ,Acid-Base Equilibrium ,Aged, 80 and over ,business.industry ,Metabolic acidosis ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Bicarbonates ,chemistry ,Disease Progression ,Female ,Acidosis ,Complication ,business ,Biomarkers ,Glomerular Filtration Rate ,Kidney disease - Abstract
Amelioration of hyperchloremic acidosis (Cl-Ac), a common complication in chronic kidney disease (CKD), could preserve renal function in chronic kidney disease (CKD). However, the development of Cl-Ac in CKD has not been clarified yet. The degree of Cl-Ac, which is indicated as the bicarbonate concentration decrease with serum chloride concentration increase (∆[HCO3–]Cl), was compared with the estimated glomerular filtration rate (eGFR) by using CKD patient records. In 307 records with metabolic acidosis, a spline curve obtained from the plot comparing ∆[HCO3–]Cl with eGFR showed that ∆[HCO3–]Cl did not change, increased, and decreased during eGFR decrease until 27, from 27 to 17.5, and from 17.5 mL/min/1.73 m2, respectively. By CKD progression, Cl-Ac progressed and regressed at the CKD stages G4 and G5, respectively. The regression would have reflected the shift of Cl-Ac to high anion gap acidosis.
- Published
- 2020
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