Abstract

VARIABILITY AND INFLUENCE OF ACID-BASE BALANCE IN PATIENTS WITH RENAL DYSFUNCTION

Minnu Anna Chacko*, Akshatha G., Anitha Vani M. and K. A. Sridhar

ABSTRACT

An acid-base imbalance is the most common complication of renal dysfunction and appears to contribute to the progression of kidney disease, hence it is necessary to understand the acid- base physiology and management of acid-base imbalance in renal dysfunction patients. To study the variability and influence of acid-base balance in patients with renal dysfunction. This was a prospective and observational study which was performed on 102 renal dysfunction patients, by enrolling the subjects based on the inclusion and exclusion criteria using a statistical method. Among 102 patients included in the study, the majority 72.42% were males and 31.62% were females, frequency of patients suffering from CKD (64.70%) was found to be higher than AKI (15.68%) and acute on CKD (19.60%). According to serum bicarbonates level, it was found that 47.06% of subjects had metabolic acidosis, 39.22% had a normal range of bicarbonates and 13.72% had metabolic alkalosis. Distribution of drugs used for the management of acid-base imbalance in renal failure showed that loop diuretics and thiazide diuretics were effective and dialysis was recommended for patients whose potassium levels and serum creatinine levels were high. PPI’S were prescribed to counteract the GI side effects of the drugs and to maintain the pH of the blood. Around 15-20% of renal dysfunction patients suffer from some degree of acid-base imbalance (commonly metabolic acidosis) and prevalence increases with lower GFR. Hence, we have undertaken the responsibility of clinical pharmacist to understand and analyze the influence and variability of acid-base changes in renal dysfunction.

Keywords: Acid-base balance, acid-base imbalance management, patient-specific management.