METABOLIC ACIDOSIS: A RISKFACTOR INACUTE KIDNEY INJURY

Abstract

Background:  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. The objective of this study was to ascertain the acid base balance status of patients of acute kidney disease patients.

Methods:  Fifty patients those who developed   acute kidney disease during hospitalization in government medical college, Aurangabad were included in this study.

Results:  Mortality in patients with pH level <7.35 was 50% (3 out of 5). While in pH level of 7.35-7.45 was 29.4% (10 out of 34) and mortality in pH level more than 7.45 was 20% (2 out of 10) p value was significant (0.031). Mortality in patients with bicarbonate level less than 22 meq/l was 50 %, while in those with bicarbonate level 22-26 meq/l was 33.3 % and in those with level >26 meq/l was 25%. Thus there is higher rate of mortality in patients with bicarbonate level <22 meq/l (p value 0.11). 

Conclusion: The results show that acidosis especially metabolic acidosis with decreased bicarbonate levels were contributors to the incidence of AKI and found that they can be the predictors of hospital mortality.   As the blood pH level decreases <7.3 and bicarbonate level<22 meq/l mortality was increasing and 100% mortality was found below pH 7.2 and bicarbonate below 20 meq/l.

Key words:  Acute kidney injury, Acid –base, Metabolic acidosis, serum bicarbonate.