Evaluation of metabolic acidosis in patients with a kidney graft: Comparison of the bicarbonate-based and strong ion-based methods

F. Abdulraof Menesi, D. Verzola, B. Villaggio, R. Russo, A. Sofia, I. Fontana, A. Gallina, I. Mannucci, M. Mussap, G. Garibotto

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: According to the traditional bicarbonate-based approach, metabolic acidosis is highly prevalent in kidney transplant recipients. However, the bicarbonate-based approach has been questioned by intensivists using strong ion difference-based methods. Methods: We compared the results obtained by the strong ion-based with the traditional approach based on bicarbonate among a cohort of 83 kidney transplant recipients. Results: Fifty-five percent of the patients were acidotic based on venous bicarbonate (effective) (effective were linearly correlated (r = 0.94; P <.0001), with a slope close to 1. A greater percentage of patients presented with an increase in unexplained anions by the strong ion gap (SIG) than by the anion gap corrected (AGcorrected) method (42 vs 32%, respectively). AGcorrected and SIG were directly related (r = 0.919; P <.0001), but the best fit of the relationship was polynomial with a progressively greater effect on SIG with increased AGcorrected, suggesting that as anions progressively accumulate, their detection by SIG increases. By multiple regression analysis, plasma chloride, potassium, uric acid, and phosphate predicted blood bicarbonate. Analogously, chloride, potassium and uric acid predicted SIDeffective. Age was a predictor of changes in AGcorrected, whereas age and plasma urea predicted SIG. Conclusions: The use of the SID yielded results that were similar to the traditional bicarbonate-based approach. Conversely, SIG appeared to be more sensitive than AG for detection of anion accumulation among patients with a kidney graft.

Original languageEnglish
Pages (from-to)1055-1062
Number of pages8
JournalTransplantation Proceedings
Volume43
Issue number4
DOIs
Publication statusPublished - May 2011

Fingerprint

Bicarbonates
Acidosis
Ions
Transplants
Kidney
Acid-Base Equilibrium
Anions
Uric Acid
Sudden Infant Death
Potassium Chloride
Urea
Chlorides
Regression Analysis

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Evaluation of metabolic acidosis in patients with a kidney graft : Comparison of the bicarbonate-based and strong ion-based methods. / Abdulraof Menesi, F.; Verzola, D.; Villaggio, B.; Russo, R.; Sofia, A.; Fontana, I.; Gallina, A.; Mannucci, I.; Mussap, M.; Garibotto, G.

In: Transplantation Proceedings, Vol. 43, No. 4, 05.2011, p. 1055-1062.

Research output: Contribution to journalArticle

Abdulraof Menesi, F, Verzola, D, Villaggio, B, Russo, R, Sofia, A, Fontana, I, Gallina, A, Mannucci, I, Mussap, M & Garibotto, G 2011, 'Evaluation of metabolic acidosis in patients with a kidney graft: Comparison of the bicarbonate-based and strong ion-based methods', Transplantation Proceedings, vol. 43, no. 4, pp. 1055-1062. https://doi.org/10.1016/j.transproceed.2011.01.120
Abdulraof Menesi, F. ; Verzola, D. ; Villaggio, B. ; Russo, R. ; Sofia, A. ; Fontana, I. ; Gallina, A. ; Mannucci, I. ; Mussap, M. ; Garibotto, G. / Evaluation of metabolic acidosis in patients with a kidney graft : Comparison of the bicarbonate-based and strong ion-based methods. In: Transplantation Proceedings. 2011 ; Vol. 43, No. 4. pp. 1055-1062.
@article{d8f06018585c4309bf0b8491b94af14d,
title = "Evaluation of metabolic acidosis in patients with a kidney graft: Comparison of the bicarbonate-based and strong ion-based methods",
abstract = "Background: According to the traditional bicarbonate-based approach, metabolic acidosis is highly prevalent in kidney transplant recipients. However, the bicarbonate-based approach has been questioned by intensivists using strong ion difference-based methods. Methods: We compared the results obtained by the strong ion-based with the traditional approach based on bicarbonate among a cohort of 83 kidney transplant recipients. Results: Fifty-five percent of the patients were acidotic based on venous bicarbonate (effective) (effective were linearly correlated (r = 0.94; P <.0001), with a slope close to 1. A greater percentage of patients presented with an increase in unexplained anions by the strong ion gap (SIG) than by the anion gap corrected (AGcorrected) method (42 vs 32{\%}, respectively). AGcorrected and SIG were directly related (r = 0.919; P <.0001), but the best fit of the relationship was polynomial with a progressively greater effect on SIG with increased AGcorrected, suggesting that as anions progressively accumulate, their detection by SIG increases. By multiple regression analysis, plasma chloride, potassium, uric acid, and phosphate predicted blood bicarbonate. Analogously, chloride, potassium and uric acid predicted SIDeffective. Age was a predictor of changes in AGcorrected, whereas age and plasma urea predicted SIG. Conclusions: The use of the SID yielded results that were similar to the traditional bicarbonate-based approach. Conversely, SIG appeared to be more sensitive than AG for detection of anion accumulation among patients with a kidney graft.",
author = "{Abdulraof Menesi}, F. and D. Verzola and B. Villaggio and R. Russo and A. Sofia and I. Fontana and A. Gallina and I. Mannucci and M. Mussap and G. Garibotto",
year = "2011",
month = "5",
doi = "10.1016/j.transproceed.2011.01.120",
language = "English",
volume = "43",
pages = "1055--1062",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Evaluation of metabolic acidosis in patients with a kidney graft

T2 - Comparison of the bicarbonate-based and strong ion-based methods

AU - Abdulraof Menesi, F.

AU - Verzola, D.

AU - Villaggio, B.

AU - Russo, R.

AU - Sofia, A.

AU - Fontana, I.

AU - Gallina, A.

AU - Mannucci, I.

AU - Mussap, M.

AU - Garibotto, G.

PY - 2011/5

Y1 - 2011/5

N2 - Background: According to the traditional bicarbonate-based approach, metabolic acidosis is highly prevalent in kidney transplant recipients. However, the bicarbonate-based approach has been questioned by intensivists using strong ion difference-based methods. Methods: We compared the results obtained by the strong ion-based with the traditional approach based on bicarbonate among a cohort of 83 kidney transplant recipients. Results: Fifty-five percent of the patients were acidotic based on venous bicarbonate (effective) (effective were linearly correlated (r = 0.94; P <.0001), with a slope close to 1. A greater percentage of patients presented with an increase in unexplained anions by the strong ion gap (SIG) than by the anion gap corrected (AGcorrected) method (42 vs 32%, respectively). AGcorrected and SIG were directly related (r = 0.919; P <.0001), but the best fit of the relationship was polynomial with a progressively greater effect on SIG with increased AGcorrected, suggesting that as anions progressively accumulate, their detection by SIG increases. By multiple regression analysis, plasma chloride, potassium, uric acid, and phosphate predicted blood bicarbonate. Analogously, chloride, potassium and uric acid predicted SIDeffective. Age was a predictor of changes in AGcorrected, whereas age and plasma urea predicted SIG. Conclusions: The use of the SID yielded results that were similar to the traditional bicarbonate-based approach. Conversely, SIG appeared to be more sensitive than AG for detection of anion accumulation among patients with a kidney graft.

AB - Background: According to the traditional bicarbonate-based approach, metabolic acidosis is highly prevalent in kidney transplant recipients. However, the bicarbonate-based approach has been questioned by intensivists using strong ion difference-based methods. Methods: We compared the results obtained by the strong ion-based with the traditional approach based on bicarbonate among a cohort of 83 kidney transplant recipients. Results: Fifty-five percent of the patients were acidotic based on venous bicarbonate (effective) (effective were linearly correlated (r = 0.94; P <.0001), with a slope close to 1. A greater percentage of patients presented with an increase in unexplained anions by the strong ion gap (SIG) than by the anion gap corrected (AGcorrected) method (42 vs 32%, respectively). AGcorrected and SIG were directly related (r = 0.919; P <.0001), but the best fit of the relationship was polynomial with a progressively greater effect on SIG with increased AGcorrected, suggesting that as anions progressively accumulate, their detection by SIG increases. By multiple regression analysis, plasma chloride, potassium, uric acid, and phosphate predicted blood bicarbonate. Analogously, chloride, potassium and uric acid predicted SIDeffective. Age was a predictor of changes in AGcorrected, whereas age and plasma urea predicted SIG. Conclusions: The use of the SID yielded results that were similar to the traditional bicarbonate-based approach. Conversely, SIG appeared to be more sensitive than AG for detection of anion accumulation among patients with a kidney graft.

UR - http://www.scopus.com/inward/record.url?scp=79957582218&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957582218&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2011.01.120

DO - 10.1016/j.transproceed.2011.01.120

M3 - Article

C2 - 21620052

AN - SCOPUS:79957582218

VL - 43

SP - 1055

EP - 1062

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 4

ER -