CHANGES IN ACID-BASE BALANCE OF UREMIC PATIENTS DURING HEMODIALYSIS 1

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Abstract
The changes in the acid-base balance during hemodialysis have been studied in 10 uremic patients. Nine of the patients were acidotic with a lowered serum pH. All 10 patients had a primary metabolic acidosis with a diminished whole blood buffer base concn. due to a decreased concn. of both the protein and bicarbonate anions. Five patients had a secondary resplratory alkalosis. Hemodialysis alleviated the acidosis; increased the buffer base concn., primarily by increasing the bicarbonate fraction; increased the total serum base concn., and removed non-chloride "fixed acids," but at the same time corrected hypochloremia. The resplratory alkalosis, when present, persisted unchanged throughout dialysis. The relationships between these changes in the acid-base balance and clinical improvement following hemodialysis are discussed.