Acid-base variables in patients with acute kidney injury requiring peritoneal dialysis in the pediatric cardiac care unit

Hiroshi Morimatsu, Yuichiro Toda, Moritoki Egi, Kazuyoshi Shimizu, Takashi Matsusaki, Satoshi Suzuki, Tatsuo Iwasaki, Kiyoshi Morita

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2 Citations (Scopus)

Abstract

Purpose: We aimed to clarify the acid-base abnormalities of patients with acute kidney injury (AKI) requiring peritoneal dialysis (PD) in pediatric cardiac care units. Methods: A retrospective observational study was conducted in a pediatric cardiac care unit in a tertiary care university hospital. The subjects were 40 patients with AKI requiring PD between 2003 and 2005, and controls matched by type of surgery and body weight. Acid-base variables, including blood gas data and electrolytes, were assessed. The Stewart-Figge variables, including strong ion difference apparent (SIDa), strong ion difference effective (SIDe), and strong ion gap (SIG), were calculated. Results: Blood gas analyses showed that the PD group was more acidemic, with a lower mean bicarbonate and a lower mean base excess, typical features of metabolic acidosis. The strong ion analyses revealed that the PD group had lower mean sodium and albumin concentrations. Based on the Stewart-Figge methodology, SIDa was smaller in the PD group than in the control group, but SIG was similar in the two groups. Receiver-operating characteristic curve analyses showed that serum albumin was the only prognostic factor associated with PCCU mortality, even after adjustment for PD treatment. Conclusion: Patients with AKI requiring PD in a pediatric cardiac care unit had significant metabolic acidosis compared to controls matched by the type of surgery and body weight. Hyponatremia and hypoalbuminemia were characteristics of these patients. The calculated SIDa was smaller in the PD than in the control group. Only the serum albumin had a significant prognostic value.

Original languageEnglish
Pages (from-to)334-340
Number of pages7
JournalJournal of Anesthesia
Volume23
Issue number3
DOIs
Publication statusPublished - 2009

Fingerprint

Peritoneal Dialysis
Acute Kidney Injury
Pediatrics
Ions
Acids
Acidosis
Serum Albumin
Body Weight
Hypoalbuminemia
Control Groups
Blood Gas Analysis
Hyponatremia
Tertiary Healthcare
Bicarbonates
ROC Curve
Electrolytes
Observational Studies
Albumins
Retrospective Studies
Gases

Keywords

  • Acid-base balance
  • Acute kidney injury
  • Cardiac surgery
  • Pediatric
  • Peritoneal dialysis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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title = "Acid-base variables in patients with acute kidney injury requiring peritoneal dialysis in the pediatric cardiac care unit",
abstract = "Purpose: We aimed to clarify the acid-base abnormalities of patients with acute kidney injury (AKI) requiring peritoneal dialysis (PD) in pediatric cardiac care units. Methods: A retrospective observational study was conducted in a pediatric cardiac care unit in a tertiary care university hospital. The subjects were 40 patients with AKI requiring PD between 2003 and 2005, and controls matched by type of surgery and body weight. Acid-base variables, including blood gas data and electrolytes, were assessed. The Stewart-Figge variables, including strong ion difference apparent (SIDa), strong ion difference effective (SIDe), and strong ion gap (SIG), were calculated. Results: Blood gas analyses showed that the PD group was more acidemic, with a lower mean bicarbonate and a lower mean base excess, typical features of metabolic acidosis. The strong ion analyses revealed that the PD group had lower mean sodium and albumin concentrations. Based on the Stewart-Figge methodology, SIDa was smaller in the PD group than in the control group, but SIG was similar in the two groups. Receiver-operating characteristic curve analyses showed that serum albumin was the only prognostic factor associated with PCCU mortality, even after adjustment for PD treatment. Conclusion: Patients with AKI requiring PD in a pediatric cardiac care unit had significant metabolic acidosis compared to controls matched by the type of surgery and body weight. Hyponatremia and hypoalbuminemia were characteristics of these patients. The calculated SIDa was smaller in the PD than in the control group. Only the serum albumin had a significant prognostic value.",
keywords = "Acid-base balance, Acute kidney injury, Cardiac surgery, Pediatric, Peritoneal dialysis",
author = "Hiroshi Morimatsu and Yuichiro Toda and Moritoki Egi and Kazuyoshi Shimizu and Takashi Matsusaki and Satoshi Suzuki and Tatsuo Iwasaki and Kiyoshi Morita",
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language = "English",
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pages = "334--340",
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TY - JOUR

T1 - Acid-base variables in patients with acute kidney injury requiring peritoneal dialysis in the pediatric cardiac care unit

AU - Morimatsu, Hiroshi

AU - Toda, Yuichiro

AU - Egi, Moritoki

AU - Shimizu, Kazuyoshi

AU - Matsusaki, Takashi

AU - Suzuki, Satoshi

AU - Iwasaki, Tatsuo

AU - Morita, Kiyoshi

PY - 2009

Y1 - 2009

N2 - Purpose: We aimed to clarify the acid-base abnormalities of patients with acute kidney injury (AKI) requiring peritoneal dialysis (PD) in pediatric cardiac care units. Methods: A retrospective observational study was conducted in a pediatric cardiac care unit in a tertiary care university hospital. The subjects were 40 patients with AKI requiring PD between 2003 and 2005, and controls matched by type of surgery and body weight. Acid-base variables, including blood gas data and electrolytes, were assessed. The Stewart-Figge variables, including strong ion difference apparent (SIDa), strong ion difference effective (SIDe), and strong ion gap (SIG), were calculated. Results: Blood gas analyses showed that the PD group was more acidemic, with a lower mean bicarbonate and a lower mean base excess, typical features of metabolic acidosis. The strong ion analyses revealed that the PD group had lower mean sodium and albumin concentrations. Based on the Stewart-Figge methodology, SIDa was smaller in the PD group than in the control group, but SIG was similar in the two groups. Receiver-operating characteristic curve analyses showed that serum albumin was the only prognostic factor associated with PCCU mortality, even after adjustment for PD treatment. Conclusion: Patients with AKI requiring PD in a pediatric cardiac care unit had significant metabolic acidosis compared to controls matched by the type of surgery and body weight. Hyponatremia and hypoalbuminemia were characteristics of these patients. The calculated SIDa was smaller in the PD than in the control group. Only the serum albumin had a significant prognostic value.

AB - Purpose: We aimed to clarify the acid-base abnormalities of patients with acute kidney injury (AKI) requiring peritoneal dialysis (PD) in pediatric cardiac care units. Methods: A retrospective observational study was conducted in a pediatric cardiac care unit in a tertiary care university hospital. The subjects were 40 patients with AKI requiring PD between 2003 and 2005, and controls matched by type of surgery and body weight. Acid-base variables, including blood gas data and electrolytes, were assessed. The Stewart-Figge variables, including strong ion difference apparent (SIDa), strong ion difference effective (SIDe), and strong ion gap (SIG), were calculated. Results: Blood gas analyses showed that the PD group was more acidemic, with a lower mean bicarbonate and a lower mean base excess, typical features of metabolic acidosis. The strong ion analyses revealed that the PD group had lower mean sodium and albumin concentrations. Based on the Stewart-Figge methodology, SIDa was smaller in the PD group than in the control group, but SIG was similar in the two groups. Receiver-operating characteristic curve analyses showed that serum albumin was the only prognostic factor associated with PCCU mortality, even after adjustment for PD treatment. Conclusion: Patients with AKI requiring PD in a pediatric cardiac care unit had significant metabolic acidosis compared to controls matched by the type of surgery and body weight. Hyponatremia and hypoalbuminemia were characteristics of these patients. The calculated SIDa was smaller in the PD than in the control group. Only the serum albumin had a significant prognostic value.

KW - Acid-base balance

KW - Acute kidney injury

KW - Cardiac surgery

KW - Pediatric

KW - Peritoneal dialysis

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