{"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":1784945762794,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acid\u2010base assessment of patients receiving conventional hemodialysis (<jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>) has been based solely on predialysis serum [total <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>], and treatment is currently driven by the <jats:styled-content style=\"fixed-case\">KDOQI<\/jats:styled-content> guideline from 2000. This guideline was directed solely at minimizing metabolic acidosis and thereby improving bone and muscle metabolism. In 2000, no data were available to assess the effects of acid\u2010base status on morbidity and mortality. Since then, new data have emerged from several large cohort studies about the association between variations in predialysis serum [total <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>], as well as blood <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>, and morbidity and mortality risk. These studies have shown increased risk not only with very low predialysis [total <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>] values, but also with predialysis alkaline <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> and very high predialysis serum [total <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>] values. At present, our major concern is not for patients with metabolic acidosis, but rather for the growing numbers of patients with metabolic alkalosis. This review discusses the controversies around assessing and treating acid\u2010base status in <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content> patients, and recommends a practical approach based on the results of these recent studies. The new approach provides recommendations for patients both with very low and very high predialysis serum [total <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>] values.<\/jats:p>","DOI":"10.1111\/sdi.12682","type":"journal-article","created":{"date-parts":[[2018,3,2]],"date-time":"2018-03-02T00:56:37Z","timestamp":1519952197000},"page":"382-387","source":"Crossref","is-referenced-by-count":17,"title":["Acid\u2010base assessment of patients receiving hemodialysis. What are our management goals?"],"prefix":"10.1111","volume":"31","author":[{"given":"F. 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