Assessment of Acid Base and Electrolyte Status in Patients with Chronic Kidney Disease

Abstract

Background: Blood gas measurements are being used to evaluate oxygenation and acid/base status. They are typically ordered if a patient has worsening symptoms of an acid/base imbalance, difficulty in breathing or shortness of breath. Blood gas analysis has been a cornerstone in the management of acutely ill patients with presumed acid/base and electrolyte imbalance.

Objective: The aim of this study was to study the blood gases and electrolyte status in patients with chronic kidney disorder.

Methods: A prospective study was conducted in the department of Clinical Biochemistry, Sher-I Kashmir Institute of Medical Sciences (SKIMS) Srinagar. A total of 171 patients were included in the study of which 91 were males and 80 were females. The age of the patients ranged between 4 - 80 years. These patients were admitted in the Nephrology ward of SKIMS. Out of these 171 patients included in the study 99 had CKD, 42 had ARF, 11 had metabolic acidosis, 6 had nephritic syndrome, 2 had lupus nephritis and 11 had complications like dysuria, HTN, glomerular diseases etc. The medical history of the patients with CKD was recorded and Samples were obtained for blood gas analysis. Venous samples were obtained for VBG analysis and arterial samples were obtained for ABG analysis. These samples were analysed for determining the blood gas status. Hemoglobin levels and kidney function test were performed manually. Hemoglobin was estimated by cyanmet-hemoglobin method. Urea was estimated by Diacetyl monoxime (DAM) method. Creatinine was estimated by Jaffe’s reaction.

Results: CKD patients showed acidosis, hypocapnia and hypoxia. Among electrolytes almost all the patients with CKD had hyponatremia and increased anion gap. Conclusion: It was concluded from the observation that male predominance was seen in chronic kidney disease. Blood gas parameters including pH, PCO2, PO2, HCO3 were found to be deranged in most of the patients with CKD. Among electrolytes sodium was found to be mostly deranged in patients with CKD and Anemia was the most common finding in patients with this disorder. JMS 2013; 16(2):86-89