EFFECT OF SODIUM BICARBONATE SUPPLEMENTATION ON IMPROVING NUTRITIONAL STATUS AMONGST PATIENTS ON MAINTENANCE HAEMODIALYSIS
Keywords:
Biomarkers, End stage renal disease, Metabolic acidosis, Nutritional status, Pakistan, Renal dialysisAbstract
Background: Patients undergoing maintenance haemodialysis for end stage renal disease are frequently frail and malnourished due to various metabolic and uremic insults. This study was conducted to determine effect of sodium bicarbonate supplementation on nutritional status of patients on maintenance haemodialysis. Methods: This clinical trial was carried out at dialysis unit of Pak Emirates Military Hospital Rawalpindi on adult haemodialysis patients with serum bicarbonate <23 mmol/L. Patients with active infections, haemodialysis for less than 6 months, limb amputation, and those on sodium bicarbonate therapy were excluded. They were randomized to receive sodium bicarbonate 600 mg three times a day in addition to usual care, or usual care alone. Anthropometric data including weight, hand grip strength, mid-arm circumference, triceps skin fold thickness, and laboratory parameters were compared amongst the two groups at baseline and after 3 months. Changes in these parameters were also compared amongst the two groups. Results: There were 32 patients, mean age of 51.38±16.37 years. There was significant increase in dry weight (1.76±1.59 vs -0.31±1.81 kg), hand grip strength (2.37±2.80 kg vs -0.97±3.39 kg), mid arm circumference (1.14±1.26 vs -1.12±1.05 cm), haemoglobin (1.02±1.57 vs -0.16±1.38 g/dL), serum albumin (3.37±2.75 vs -2.00±1.50 g/L) and bicarbonate (7.98±3.38 vs -1.44±2.46 mmol/L) in the intervention arm as compared with the control group, respectively. Triceps skinfold thickness fell in both arms, and to a greater extent in the intervention arm (-1.20±1.10 vs -0.19±1.58 mm). A greater proportion of patients who received bicarbonate therapy had elevation in blood pressure as compared to control group (68.75% vs 25.00%). Conclusion: Sodium bicarbonate supplementation significantly improved nutritional status of patients on maintenance haemodialysis.
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