Chloride, but not unmeasured anions, is correlated with renal bone disease markers.

Abstract

BACKGROUND:

Many factors are involved in the progression of secondary hyperparathyroidism, including acidosis. Stewart's approach has made it possible to identify real determinants of acid-base status, making chloride a real etiological factor of acid-base disturbances. In addition, it has allowed the quantification of the components of these disturbances, especially the unmeasured anions. We performed a cross-sectional study to quantify each component of acidosis in hemodialysis patients and correlate them with renal bone disease biochemical markers.

METHODS:

Sixty maintenance hemodialysis patients and 14 controls were enrolled in this study. Each acid-base determinant was quantified and correlated in multivariate regression with intact serum parathormone and bone-specific alkaline phosphatase, adjusting to other variables.

RESULTS:

Hemodialysis patients were more acidotic than controls, mainly due to the retention of unmeasured anions, hyperchloremia and hyperphosphatemia. In multivariate regression analysis, the only acid-base determinants independently correlated with bone markers were chloride, calcium and phosphorus (beta=0.537, beta=-0.256 and beta=-0.242, respectively). Although unmeasured anions were a major component of acidosis, they had no correlation with these markers.

CONCLUSION:

Although unmeasured anions are considered the main component of acidosis in hemodialysis patients, serum chloride was the only acid-base determinant correlated with bone markers.

• Authors: Alexandre Braga Libório, Danilo Teixeira Noritomi, Manuel Carlos Martins de Castro
• Journal: Journal of nephrology (J Nephrol) 2007 Jul-Aug Vol. 20 Issue 4 Pg. 474-81 ISSN: 1121-8428 [Print] Italy
• PMID: 17879215 (Publication Type: Journal Article)

Chemical References

• Anions
• Biomarkers
• Chlorides
• Parathyroid Hormone

Topics

• Acid-Base Equilibrium
• Acidosis (diagnosis, etiology)
• Adult
• Anions (blood)
• Biomarkers (blood)
• Chlorides (blood)
• Chronic Kidney Disease-Mineral and Bone Disorder (diagnosis, etiology)
• Female
• Humans
• Male
• Middle Aged
• Parathyroid Hormone (blood)
• Renal Dialysis (adverse effects)