Rezende Luiza Raksa, Souza Pablo Brandão de, Pereira Giselly Rosa Modesto, Lugon Jocemir Ronaldo
Universidade Federal Fluminense.
J Bras Nefrol. 2017 Jul-Sep;39(3):305-311. doi: 10.5935/0101-2800.20170053.
Metabolic acidosis is highly prevalent in hemodialysis patients. The disorder is associated with increased mortality and its deleterious effects are already present in the predialysis phase of chronic kidney disease. Metabolic acidosis has been linked to progression of chronic kidney disease, changes in protein and glucose metabolism, bone and muscle disorders and cardiovascular disease. At present, the control of metabolic acidosis in hemodialysis is mainly focused on the supply of bicarbonate during dialysis session, but further studies are needed to set the optimum target serum bicarbonate and the best concentration of the bicarbonate dialysate. The present study reviews pathophysiological and epidemiological aspects of metabolic acidosis in hemodialysis patients and also addresses its adverse effects and treatment.
代谢性酸中毒在血液透析患者中极为常见。这种病症与死亡率增加相关，并且在慢性肾脏病的透析前阶段就已存在有害影响。代谢性酸中毒与慢性肾脏病的进展、蛋白质和葡萄糖代谢变化、骨骼和肌肉疾病以及心血管疾病有关。目前，血液透析中代谢性酸中毒的控制主要集中在透析过程中补充碳酸氢盐，但仍需要进一步研究来确定最佳的目标血清碳酸氢盐水平和碳酸氢盐透析液的最佳浓度。本研究回顾了血液透析患者代谢性酸中毒的病理生理和流行病学方面，并探讨了其不良影响及治疗方法。
