Metabolic acidosis in patients after kidney transplantation

Katarzyna Skiba, Damian Gojowy, Magdalena Szotowska, Magdalena Bartmańska, Aureliusz Kolonko, Lech Cierpka, Andrzej Więcek, Marcin Adamczak
2018 Polish Archives of Internal Medicine  
INTRODUCTION Metabolic acidosis (MA) may accelerate the progression of chronic kidney disease (CKD) and is an important risk factor for increased mortality in CKD patients. The clinical value of MA in kidney transplant (KTx) recipients has not been extensively studied so far. OBJECTIVES The aim of this clinical single -center case -control study was to assess the prevalence of MA in KTx recipients in comparison with CKD patients and to identify pathogenic factors for MA in KTx recipients.
more » ... TS AND METHODS Venous blood concentrations of bicarbonate (HCO 3 -) and blood hemoglobin concentrations were measured in 500 KTx recipients and 500 CKD patients matched for sex, age, and estimated glomerular filtration rate (eGFR). None of these patients received alkali treatment before the study. MA was diagnosed in KTx recipients with HCO 3 levels lower than 22 mmol/l. RESULTS The prevalence of MA was lower in KTx recipients than in CKD patients (12.0% vs 19.6%; P = 0.001). In both groups, the prevalence increased with progression of CKD stages (P <0.001 for trend) and was higher in patients with anemia. In a multivariable analysis, hemoglobin concentrations correlated independently with eGFR and HCO 3 in KTx recipients (β = 0.314, P <0.001 and β = 0.274, P <0.001, respectively). Similar correlations were observed in CKD patients (β = 0.273, P <0.001 and β = 0.123, P = 0.006, respectively). CONCLUSIONS Our study revealed that the prevalence of MA is lower in KTx recipients than in CKD patients. Moreover, in KTx recipients, blood bicarbonate concentrations are related to kidney function and blood hemoglobin concentrations. Neth J Med. 2007; 65: 75-77. 4 Mak RH. Effect of metabolic acidosis on branched -chain amino acids in uremia. Pediatr Nephrol. 1999; 13: 319-322.  5 Raj DS, Sun Y, Tzamaloukas AH. Hypercatabolism in dialysis patients.
doi:10.20452/pamw.4329 pmid:30207550 fatcat:veqo7yvfbbd5zgkigwy55f7zta