Analysis Of Related Risk Factors Of Metabolic Acidosis In Patients With Maintenance Hemodialysis In Xining

Objective:Metabolic acidosis（MA）status during maintenance hemodialysis（MHD）treatment interval in patients with end-stage renal disease（ESRD）affects the quality of dialysis and prognosis,and there are few studies on this aspect at high altitudes.The purpose of this study is to understand the occurrence of MA in ESRD patients in the Xining area during the MHD treatment interval and to further explore the related risk factors and adverse outcomes of occurrence of MA.The purpose of this study is also to provide clinical ideas for achieving a steady state of acid-base status in patients treated with MHD,improving the quality of MHD treatment,and improving the prognosis of patients.Methods:The subjects of the study were patients who were diagnosed with ESRD and received MHD treatment from November 2020 to August 2021 in the Hemodialysis Center of Nephrology Department of Affiliated Hospital of Qinghai University.Based on the concentration of blood bicarbonate（HCO₃^-）,the patients were divided into the following two groups:MA group（HCO₃^-≤21 mmol/L）and non-MA group（HCO₃^->21 mmol/L）.The general data,clinical data,laboratory data,transferrin saturation（TSAT）,estimated glomerular filtration rate（e GFR）,product of calcium and phosphorus（Ca×P）,Kt/V value of patients were collected.All relevant data of the two groups of patients were sorted,compared and analyzed,and the related risk factors of occurrence of MA in patients with MHD treatment interval were discussed.Results:1.According to the inclusion and exclusion criteria,a total of 67 cases were selected,including 41 males and 26 females,accounting for 61.2%and 38.8%respectively,with a male-female ratio of 1.58:1;Among them,chronic glomerulonephritis and diabetic nephropathy were the most important primary types,accounting for 32 cases（47.8%）and 20 cases（29.9%）;among the selected cases,34cases（50.7%）had MA,and 33 cases（49.3%）did not.2.The comparison between groups showed that smoking,drinking,red blood cells（RBC）,hematocrit（Hct）,hemoglobin（Hb）,unsaturated iron-binding capacity（UIBC）,blood urea nitrogen（BUN）,blood potassium（K⁺）,urine output,albumin（ALB）,ejection fraction（EF）were significant differences（P<0.05）,compared with non-MA group,patients in MA group had more smoking and drinking,higher levels of BUN,K⁺,RBC,Hct,Hb,and lower levels of UIBC,urine output,ALB,and EF.3.Binary logistic regression analysis was performed on some data with statistical significance between the above two groups.The results showed that the risk factors of MA were smoking,drinking,BUN,K⁺and Hb.4.The Pearson correlation analysis was performed between the concentration of HCO₃^-and the level of ALB,and the results indicated that there was a correlation between them（P<0.05）.5.Gamma test was performed to analyze the correlation between the degree of MA and the grade of cardiac function,indicating that there was a correlation between them.（Gamma=0.632,P<0.001）.Conclusion:1.Smoking,drinking,BUN,K⁺,and Hb were the related risk factors of occurrence of MA in ESRD patients in this study during the MHD treatment interval.2.There was a positive correlation between the concentration of HCO₃^-and the level of ALB.3.There was a positive correlation between the degree of MA and the grade of cardiac function.