Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality
Open Access
- 30 March 2017
- journal article
- Published by Spandidos Publications in Experimental and Therapeutic Medicine
- Vol. 13 (5), 2362-2374
- https://doi.org/10.3892/etm.2017.4292
Abstract
Metabolic acidosis has been proved to be a risk factor for the progression of chronic kidney disease, but its relation to acute kidney injury (AKI) has not been investigated. In general, a diagnosis of metabolic acidosis is based on arterial blood gas (ABG) analysis, but the diagnostic role of carbon dioxide combining power (CO2CP) in the venous blood may also be valuable to non‑respiratory patients. This retrospective study included all adult non‑respiratory patients admitted consecutively to our hospital between October 01, 2014 and September 30, 2015. A total of 71,089 non‑respiratory patients were included, and only 4,873 patients were evaluated by ABG analysis at admission. In patients with ABG, acidosis, metabolic acidosis, decreased HCO3‑ and hypocapnia at admission was associated with the development of AKI, while acidosis and hypocapnia were independent predictors of hospital mortality. Among non‑respiratory patients, decreased CO2CP at admission was an independent risk factor for AKI and hospital mortality. ROC curves indicated that CO2CP was a reasonable biomarker to exclude metabolic acidosis, dual and triple acid‑base disturbances. The effect sizes of decreased CO2CP on AKI and hospital mortality varied according to age and different underlying diseases. Metabolic acidosis is an independent risk factor for the development of AKI and hospital mortality. In non‑respiratory patient, decreased CO2CP is also an independent contributor to AKI and mortality and can be used as an indicator of metabolic acidosis.Keywords
This publication has 16 references indexed in Scilit:
- Association of Serum Bicarbonate With Risk of Renal and Cardiovascular Outcomes in CKD: A Report From the Chronic Renal Insufficiency Cohort (CRIC) StudyAmerican Journal of Kidney Diseases, 2013
- Acidic pH via NF-κB favours VEGF-C expression in human melanoma cellsClinical & Experimental Metastasis, 2013
- KDIGO Clinical Practice Guidelines for Acute Kidney InjuryNephron Clinical Practice, 2012
- Clinical significance of acid–base balance in an emergency setting in patients with acute heart failureJournal of Cardiology, 2012
- A Randomized, Controlled, Double-Blind Crossover Study on the Effects of 2-L Infusions of 0.9% Saline and Plasma-Lyte® 148 on Renal Blood Flow Velocity and Renal Cortical Tissue Perfusion in Healthy VolunteersAnnals of Surgery, 2012
- Sodium bicarbonate supplements for treating acute kidney injuryCochrane Database of Systematic Reviews, 2012
- Understanding and managing acute fluid and electrolyte disturbancesCurrent Paediatrics, 2003
- Diagnosis of Metabolic Acid–Base Disturbances in Critically Ill PatientsAmerican Journal of Respiratory and Critical Care Medicine, 2000
- Clinical Physiology of Acid-Base and Electrolyte DisordersPublished by American Medical Association (AMA) ,1990
- Measuring the Accuracy of Diagnostic SystemsScience, 1988