Serum Electrolyte and Acid Base Composition

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Abstract
Data from 41 ambulatory patients with graded degrees of uncomplicated, chronic renal failure were used to define the quantitative relationship between serum acid-base and electrolyte composition and the serum creatinine level. Even in patients with only moderate renal insufficiency, serum total carbon dioxide (tCO2) content was reduced significantly. This early fall in tCO2was offset by an increase in serum chloride (Cl-), serum undetermined anion concentration (A-) remaining normal. In patients with more severe degrees of renal insufficiency, further decrements in tCO2occurred that were proportional to the increment in serum creatinine. These latter decrements in tCO2were associated with equivalent increments in A-, serum Cl-- remaining unchanged at the elevated level observed during moderate renal insufficiency. Confidence limits of 95% for tCO2and A were calculated from the data. (Arch Intern Med139:1099-1102, 1979)