The Characteristics of Metabolic Acidosis in Aged Patients with Chronic Renal Failure

• Published in: Nihon Rōnen Igakkai zasshi Vol. 28; no. 4; pp. 536 - 545
• Main Authors: Ito, Hideki, Shiraki, Masataka, Inoue, Junichiro, Fujimaki, Hiroshi, Takahashi, Tadao
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 01.07.1991
• Subjects: Acid-Base Equilibrium; acidosis; Acidosis - etiology; Acidosis - metabolism; Aged; anion gap; chronic renal failure; Creatinine - metabolism; Electrolytes - blood; Female; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - metabolism; Male; the aged
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.28.536

The present study was designed to clarify the characteristics of metabolic acidosis in aged patients with chronic renal failure. The subjects consisted of ambulatory cooperative patients (19 males and 18 females). Their values of creatinine clearance (Ccr) varied from 6.8 to 107.5ml/min/1.73m2. The relationship of Ccr to acid-base and electrolyte disturbances was investigated. The estimations of normal values in acid-base and electrolyte composition were based on the method of Hoffmann. The results are summarized as follows: 1. A high incidence of metabolic acidosis was demonstrated in patients whose Ccr values were below 20ml/min/1.73m2. 2. A significant positive correlation of Ccr values and plasma levels of bicarbonate (p<0.001) and a significant inverse correlation of Ccr values and serum levels of chloride (p<0.01) were observed. 3. The values of the anion gap did not change, irrespective of Ccr values. 4. Serum concentrations of potassium were inversely correlated with plasma levels of bicarbonate (p<0.01). Hyperchloremic normal anion gap acidosis with hyperpotassemia was the characteristic feature of metabolic acidosis in aged patients with chronic renal failure. The normal anion gap could be explained by normophosphatemia or mild hyperphosphatemia, even in the patients with advanced renal failure.