{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T02:16:04Z","timestamp":1784945764335,"version":"3.55.0"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100022992","name":"Clinical Trials Fund, Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022992","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the pre-dialysis serum bicarbonate concentration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective is to examine the association between the dialysate bicarbonate prescription and the pre-dialysis serum bicarbonate concentration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This is a retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>The study was performed using linked administrative health care databases in Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Prevalent adults receiving maintenance in-center hemodialysis as of April 1, 2020 (n = 5414) were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Patients were grouped into the following dialysate bicarbonate categories at the dialysis center-level: individualized (adjustment based on pre-dialysis serum bicarbonate concentration) or standardized (&gt;90% of patients received the same dialysate bicarbonate concentration). The standardized category was stratified by concentration: 35, 36 to 37, and \u226538 mmol\/L. The primary outcome was the mean outpatient pre-dialysis serum bicarbonate concentration at the patient level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We examined the association between dialysate bicarbonate category and pre-dialysis serum bicarbonate using an adjusted linear mixed model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All dialysate bicarbonate categories had a mean pre-dialysis serum bicarbonate concentration within the normal range. In the individualized category, 91% achieved a pre-dialysis serum bicarbonate \u226522 mmol\/L, compared to 87% in the standardized category. Patients in the standardized category tended to have a serum bicarbonate that was 0.25 (95% confidence interval [CI] = \u22120.93, 0.43) mmol\/L lower than patients in the individualized category. Relative to patients in the 35 mmol\/L category, patients in the 36 to 37 and \u226538 mmol\/L categories tended to have a serum bicarbonate that was 0.70 (95% CI = \u22120.30, 1.70) mmol\/L and 0.87 (95% CI = 0.14, 1.60) mmol\/L higher, respectively. There was no effect modification by age, sex, or history of chronic lung disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>We could not directly confirm that all laboratory measurements were pre-dialysis. Data on prescribed dialysate bicarbonate concentrations for individual dialysis sessions were not available, which may have led to some misclassification, and adherence to a practice of individualization could not be measured. Residual confounding is possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We found no significant difference in the pre-dialysis serum bicarbonate concentration irrespective of whether an individualized or standardized dialysate bicarbonate was used. Dialysate bicarbonate concentrations \u226538 mmol\/L (vs 35 mmol\/L) may increase the pre-dialysis serum bicarbonate concentration by 0.9 mmol\/L.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20543581241256774","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T08:35:46Z","timestamp":1717058146000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Association Between the Dialysate Bicarbonate and the Pre-dialysis Serum Bicarbonate Concentration in Maintenance Hemodialysis: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4549-0202","authenticated-orcid":false,"given":"Amber O.","family":"Molnar","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada"},{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada"},{"name":"Population Health Research Institute, McMaster University\/Hamilton Health Sciences, ON, Canada"},{"name":"St. Joseph\u2019s Healthcare Hamilton, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Killin","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Bota","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6944-6471","authenticated-orcid":false,"given":"Eric","family":"McArthur","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-6574","authenticated-orcid":false,"given":"Stephanie N.","family":"Dixon","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-3114","authenticated-orcid":false,"given":"Amit X.","family":"Garg","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada"},{"name":"Lawson Health Research Institute, London Health Sciences Centre, ON, Canada"},{"name":"Division of Nephrology, Department of Medicine, Western University, London, ON, Canada"},{"name":"Department of Epidemiology, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3109-6837","authenticated-orcid":false,"given":"Stephanie","family":"Thompson","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Tennankore","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Nova Scotia Health Authority, Halifax, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Blake","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Bohm","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Manitoba, Winnipeg, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"MacRae","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1843-6131","authenticated-orcid":false,"given":"Samuel A.","family":"Silver","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, London, ON, Canada"},{"name":"Division of Nephrology, Department of Medicine, Queen\u2019s University, Kingston, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"bibr1-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.05.006"},{"key":"bibr2-20543581241256774","volume":"35","author":"Clinical practice guidelines for nutrition in chronic renal failure","year":"2000","journal-title":"Am J Kidney Dis"},{"key":"bibr3-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(04)00936-9"},{"key":"bibr4-20543581241256774","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00010505"},{"key":"bibr5-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V84627"},{"key":"bibr6-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V84632"},{"key":"bibr7-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000080316.37254.7A"},{"key":"bibr8-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/12.12.2633"},{"key":"bibr9-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2008.08.012"},{"key":"bibr10-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.03.035"},{"key":"bibr11-20543581241256774","doi-asserted-by":"publisher","DOI":"10.5049\/EBP.2007.5.2.95"},{"key":"bibr12-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12510"},{"key":"bibr13-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12502"},{"key":"bibr14-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12842"},{"key":"bibr15-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.04.014"},{"key":"bibr16-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016070780"},{"key":"bibr17-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0125620"},{"key":"bibr18-20543581241256774","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06680810"},{"key":"bibr19-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5893.643"},{"key":"bibr20-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1080\/03610910902859574"},{"key":"bibr21-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1159\/000169029"},{"key":"bibr22-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0082912"},{"key":"bibr23-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-139x.2000.00066.x"},{"key":"bibr24-20543581241256774","doi-asserted-by":"publisher","DOI":"10.5935\/0101-2800.20150073"},{"key":"bibr25-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2003.08.021"},{"key":"bibr26-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.11.2006"},{"key":"bibr27-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(99)70077-6"},{"key":"bibr28-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1159\/000495846"},{"key":"bibr29-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn541"},{"key":"bibr30-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg383"},{"key":"bibr31-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh661"},{"key":"bibr32-20543581241256774","doi-asserted-by":"publisher","DOI":"10.5301\/jn.5000036"},{"key":"bibr33-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1159\/000368459"},{"key":"bibr34-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-014-0844-5"},{"key":"bibr35-20543581241256774","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaa058"}],"container-title":["Canadian Journal of Kidney Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20543581241256774","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20543581241256774","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20543581241256774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:21:42Z","timestamp":1777389702000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20543581241256774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":35,"alternative-id":["10.1177\/20543581241256774"],"URL":"https:\/\/doi.org\/10.1177\/20543581241256774","relation":{},"ISSN":["2054-3581","2054-3581"],"issn-type":[{"value":"2054-3581","type":"print"},{"value":"2054-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"20543581241256774"}}