Meaning of TCO2 in the Diabetic and Non-diabetic Patients Undergoing Long-term Hemodialysis / 대한신장학회잡지

ABSTRACT

OBJECTIVE: Various degrees of metabolic acidosis are accompanied by the decrease in the kidney function. It is known that dialysis patients' long-term convalescences and complications are related to metabolic acidosis. It is generally known that the extreme acidosis of the dialysis patients should be corrected but on the contrary, there are reports on hemodialysis patients with slight acidosis have better nutritional condition. However, the research results are rare compared to the ratio of diabetic patients among dialysis patients. Therefore, in this paper we tried to reach a conclusion by comparing and analyzing the total carbon dioxide of the serum and other nutrition parameters of the diabetic patients among long-term hemodialysis patients with the non-diabetic patients. METHODS: We divided 50 patients, who have been hemodialysis for longer than three months, into 21 patients with diabetes and 29 patients with non-diabetes. And we compared and analyzed the TCO2 in addition to measuring other parameters based on the blood tests carried out on the beginning of every month from January of 1999 to December of 2000. RESULTS: TCO2 showed a inverse correlation with nPCR, serum albumin, blood urea nitrogen, and creatinine on the correlation analysis of the total target patients. And blood urea nitrogen and age were the independent factors in the independent factor analysis using multiple regression analysis. When we divided and compared the total target patients into diabetic patients and non-diabetic patients, there were no significant differences between various kinds of nutrition parameters and dialysis parameters. And TCO2 showed a inverse correlation with nPCR, nPCR being the independent factor in the diabetic patients. In addition, TCO2 showed a inverse correlation with serum creatinine, serum creatinine being the independent factor in the non-diabetic patients. CONCLUSION: Increase of ingestion of protein was one of the important factors in inducing metabolic acidosis, but the TCO2 and improved nutritional condition resulting from ingesting sufficient protein could be preserved in the diabetic patients. Therefore we think that the diabetic patients' nutritional condition and supervision of their ingestion of protein is more needed as sufficient ingestion of protein is a major factor in balancing acid-base for diabetic patients than non-diabetic patients.