Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Hu,Jiachang; Wang,Yimei; Geng,Xuemei; Chen,Rongyi; Xu,Xialian; Zhang,Xiaoyan; Lin,Jing; Teng,Jie; Ding,Xiaoqiang

doi:10.3892/etm.2017.4292

May-2017 Volume 13 Issue 5

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May-2017 Volume 13 Issue 5

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Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Authors:
- Jiachang Hu
- Yimei Wang
- Xuemei Geng
- Rongyi Chen
- Xialian Xu
- Xiaoyan Zhang
- Jing Lin
- Jie Teng
- Xiaoqiang Ding
View Affiliations / Copyright

Affiliations: Division of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China

Copyright: © Hu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 2362-2374
|
Published online on: March 30, 2017

https://doi.org/10.3892/etm.2017.4292
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Abstract

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 non‑respiratory 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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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

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