期刊
EXPERIMENTAL AND THERAPEUTIC MEDICINE
卷 13, 期 5, 页码 2362-2374出版社
SPANDIDOS PUBL LTD
DOI: 10.3892/etm.2017.4292
关键词
acid-base; metabolic acidosis; carbon dioxide combining power; acute kidney injury; mortality
资金
- Shanghai Key Discipline Construction Project on the Fourth Round of Three-year Action Plan for Public Health Systems: Subject of Dialysis and Body Fluids [15GWZK0502]
- Grant of Chinese Ministry of Health
- Shanghai Science and Technology Committee Foundation (Shanghai Key Laboratory of Kidney Diseases and Blood Purification) [14DZ2260200]
Metabolic acidosis has been proved to be a risk factor for the progression of chronic kidney disease, but its relation to acute kidney injury (AKI) has not been investigated. In general, a diagnosis of metabolic acidosis is based on arterial blood gas (ABG) analysis, but the diagnostic role of carbon dioxide combining power (CO2CP) in the venous blood may also be valuable to non-respiratory patients. This retrospective study included all adult non-respiratory patients admitted consecutively to our hospital between October 01, 2014 and September 30, 2015. A total of 71,089 nonrespiratory patients were included, and only 4,873 patients were evaluated by ABG analysis at admission. In patients with ABG, acidosis, metabolic acidosis, decreased HCO3- and hypocapnia at admission was associated with the development of AKI, while acidosis and hypocapnia were independent predictors of hospital mortality. Among non-respiratory patients, decreased CO2CP at admission was an independent risk factor for AKI and hospital mortality. ROC curves indicated that CO2CP was a reasonable biomarker to exclude metabolic acidosis, dual and triple acid-base disturbances. The effect sizes of decreased CO2CP on AKI and hospital mortality varied according to age and different underlying diseases. Metabolic acidosis is an independent risk factor for the development of AKI and hospital mortality. In non-respiratory patient, decreased CO2CP is also an independent contributor to AKI and mortality and can be used as an indicator of metabolic acidosis.
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