Bicarbonate balance and prescription in ESRD

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


The optimal approach to managing acid-base balance is less well defined for patients receiving hemodialysis than for those receiving peritoneal dialysis. Interventional studies in hemodialysis have been limited and inconsistent in their findings, whereas more compelling data are available from interventional studies in peritoneal dialysis. Both high and lowserumbicarbonate levels associatewith an increased risk of mortality in patients receiving hemodialysis, but high values are a marker for poor nutrition and comorbidity and are often highly variable from month to month. Measurement of pH would likely provide useful additional data. Concern has arisen regarding high-bicarbonate dialysate and dialysis-induced alkalemia, but whether these truly cause harm remains to be determined. The available evidence is insufficient for determining the optimal target for therapy at this time.

Original languageEnglish (US)
Pages (from-to)726-734
Number of pages9
JournalJournal of the American Society of Nephrology
Issue number3
StatePublished - Mar 2017

ASJC Scopus subject areas

  • Nephrology


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