{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T02:16:02Z","timestamp":1784945762525,"version":"3.55.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Acid\u2013base assessments in hemodialysis patients have been limited almost entirely to measurements of total CO2 concentration, and assumptions have been made about the presence of acid\u2013base disorders. To gain a fuller understanding of the acid\u2013base status of stable hemodialysis patients, we analyzed measurements of pCO2, pH and HCO3\u2212 obtained in a cohort of chronic stable hemodialysis patients over a 5-year period.<\/jats:p>\n                  <jats:p>Methods: We reviewed acid\u2013base measurements taken pre-dialysis from fistula blood in 53 outpatients receiving hemodialysis thrice weekly between 2008 and 2012. In these patients, pH and pCO2 were measured using an onsite blood gas analyzer, and HCO3\u2212 was computed. Relevant clinical and laboratory data were obtained from medical records. Factors affecting serum HCO3\u2212 were identified. Simple and mixed acid\u2013base disorders were diagnosed using accepted rules.<\/jats:p>\n                  <jats:p>Results: Serum HCO3\u2212 was affected by age, normalized protein catabolic rate, interdialytic weight gain and length of interval between treatments. As expected, metabolic acidosis was the most common acid\u2013base disorder, but respiratory acid\u2013base disturbances, as simple or complex disorders, were found in 41% of the measurements. Respiratory alkalosis was seen more frequently than respiratory acidosis, but the latter disorder was more commonly associated with serious comorbidities.<\/jats:p>\n                  <jats:p>Conclusions: Respiratory acid\u2013base disorders are an important component of the acid\u2013base abnormalities seen in hemodialysis patients and are not identified by measuring total CO2 concentration; hence, complete acid\u2013base measurements are needed to determine the components of hemodialysis patients' acid\u2013base status that are contributing to mortality risk.<\/jats:p>","DOI":"10.1093\/ndt\/gfw022","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T00:15:46Z","timestamp":1458605746000},"page":"528-533","source":"Crossref","is-referenced-by-count":16,"title":["Beyond bicarbonate: complete acid\u2013base assessment in patients receiving intermittent hemodialysis"],"prefix":"10.1093","volume":"32","author":[{"given":"Marco","family":"Marano","sequence":"first","affiliation":[{"name":"1Hemodialysis Unit, Maria Rosaria Clinic, Pompeii, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Marano","sequence":"additional","affiliation":[{"name":"2Department of Information and Electrical Engineering and Applied Mathematics, University of Salerno, Fisciano, Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. John","family":"Gennari","sequence":"additional","affiliation":[{"name":"3University of Vermont, UVM Medical Center, 1 South Prospect St., Burlington, VT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,3,21]]},"reference":[{"key":"2025102312493721700_gfw022C1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/j.1525-139X.2010.00737.x","article-title":"Very low and high predialysis serum bicarbonate levels are risk factors for mortality: what are the appropriate interventions?","volume":"23","author":"Gennari","year":"2010","journal-title":"Semin Dial"},{"key":"2025102312493721700_gfw022C2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1053\/j.ajkd.2013.12.017","article-title":"Approach to the hemodialysis patient with an abnormal serum bicarbonate concentration","volume":"64","author":"Lisawat","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"2025102312493721700_gfw022C3","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1053\/j.ajkd.2015.04.014","article-title":"Predialysis and postdialysis pH and bicarbonate and risk of all-cause and cardiovascular mortality in long-term hemodialysis patients","volume":"66","author":"Yamamoto","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"2025102312493721700_gfw022C4","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/S0272-6386(04)00936-9","article-title":"Association of predialysis serum bicarbonate levels with risk of mortality and hospitalization in the Dialysis Outcomes and Practice Patterns Study (DOPPS)","volume":"44","author":"Bommer","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"2025102312493721700_gfw022C5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.2215\/CJN.00010505","article-title":"Association between serum bicarbonate and death in hemodialysis patients: is it better to be acidotic or alkalotic?","volume":"1","author":"Wu","year":"2006","journal-title":"Clin J Am Soc Nephrol"},{"key":"2025102312493721700_gfw022C6","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1053\/j.ajkd.2013.03.035","article-title":"Association of dialysate bicarbonate concentration with mortality in the dialysis outcomes and practice patterns study (DOPPS)","volume":"62","author":"Tentori","year":"2013","journal-title":"Am J Kidney Dis"},{"key":"2025102312493721700_gfw022C7","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s11255-015-0913-4","article-title":"A very simple formula to compute pCO2 in hemodialysis patients","volume":"47","author":"Marano","year":"2015","journal-title":"Int Urol Nephrol"},{"key":"2025102312493721700_gfw022C8","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1056\/NEJMra1003327","article-title":"Physiological approach to assessment of acid-base disturbances","volume":"371","author":"Berend","year":"2014","journal-title":"N Engl J Med"},{"key":"2025102312493721700_gfw022C9","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1038\/ki.1982.172","article-title":"Arterial PCO2 in chronic metabolic acidosis","volume":"22","author":"Bushinsky","year":"1982","journal-title":"Kidney Int"},{"key":"2025102312493721700_gfw022C10","first-page":"717","article-title":"Acid-base disorders in dialysis patients","volume-title":"Acid-Base Disorders and Their Treatment","author":"Gennari","year":"2005"},{"key":"2025102312493721700_gfw022C11","first-page":"200","article-title":"The importance of ultrafiltration on acid-base status in a dialysis population","volume":"34","author":"Fabris","year":"1988","journal-title":"ASAIO Trans"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/32\/3\/528\/17822359\/gfw022.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/32\/3\/528\/17822359\/gfw022.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T16:50:31Z","timestamp":1761238231000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/32\/3\/528\/3059422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,21]]},"references-count":11,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2016,3,21]]},"published-print":{"date-parts":[[2017,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfw022","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,3]]},"published":{"date-parts":[[2016,3,21]]}}}