Effects of Correction of Acidosis on Body Composition in Patients Suffering from Chronic Kidney Disease on Haemodialysis: A Prospective Interventional Study
Introduction: Metabolic acidosis is a common problem in patients with Chronic Kidney Disease (CKD) and those on maintenance haemodialysis. In resource-poor countries, financial constraints adversely affect the frequency of dialysis and compliance with medication. This leads to a worsening clinical c...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/20900/78338_CE[Ra1]_F(SHU)_QC(PS_SS)_PF1(AG_OM)_PFA_NC(IS)_PB(AG_IS)_PN(IS).pdf |
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| Summary: | Introduction: Metabolic acidosis is a common problem in patients with Chronic Kidney Disease (CKD) and those on maintenance haemodialysis. In resource-poor countries, financial constraints adversely affect the frequency of dialysis and compliance with medication. This leads to a worsening clinical condition for patients and an increased need for in-hospital care, often requiring intensive care, which further drives up treatment costs. Metabolic acidosis also has implications for bone and muscle health.
Aim: To assess the changes in body composition (fat percentage and lean body mass), changes in third space fluid, biochemical parameters, the number of admissions and the requirement for blood transfusions before and after the correction of metabolic acidosis.
Materials and Methods: This was a prospective, interventional study conducted in a tertiary care centre, Western India, in which 40 patients on maintenance haemodialysis were included. Bioelectrical Impedance Analysis (BIA) and biochemical parameters (Complete Blood Counts (CBC), renal function tests, serum calcium and phosphorus, liver function tests and blood gas analysis) were conducted at baseline before starting bicarbonate supplementation. The number of admissions and blood transfusions in the three months prior to the initiation of bicarbonate supplementation was noted. Oral bicarbonate supplementation was increased based on the baseline blood gas analysis. The same parameters were assessed after three months and analysed.
Results: At the end of three months, a significant reduction (p-value <0.05) in creatinine, Extracellular Water (ECW) and lean body mass, along with an increased body fat percentage. There was a reduction in third space fluid and ECW, with no significant changes (p-value >0.1) in the weight and Body Mass Index (BMI) of patients was observed. Additionally, there was a significant improvement (p-value <0.05) in the serum protein and albumin levels of these patients. The number of hospitalisations decreased from 28 to 13 and the number of blood transfusions required also decreased from 31 to 13.
Conclusion: The correction of acidosis improved metabolic parameters, resulting in an increase in fat percentage and a reduction in ECW and third space water without intracellular dehydration. There was a significant reduction in urea and creatinine values, as well as a significant decrease in hospitalisations and the number of blood transfusions required. |
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| ISSN: | 2249-782X 0973-709X |