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JRPMS Vol 5, No 2, June 2021, p.65-70

doi: 10.22540/JRPMS-05-065

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Review Article

Acid-base disorders and the impact on metabolic bone disease in hemodialysis patients

Eirini Evaggelou1, George I. Lambrou1,2,3

  1. Postgraduate Program “Metabolic Bones Diseases”, National and Kapodistrian University of Athens, Medical School, Goudi, Athens, Greece
  2. Laboratory for the Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Medical School, Kifissia, Athens, Greece
  3. Choremeio Research Laboratory, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Keywords: Chronic Kidney Disease, Hemodialysis, Metabolic acidosis, Mineral Bone Disorder


Abstract

Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a term that is used to describe a wider clinical syndrome that can be developed as a systemic metabolic mineral bone disturbance, due to the chronic kidney disease, and it manifests itself as metabolic mineral bone anomalies or extra-skeletal calcifications. Metabolic acidosis is considered to be the most widespread acid-base disorder that is found in the majority of CKD patients. Hemodialysis patients seem to be more prone to MBD due to acid base disorders. This article aims to review the available literature about the acid-base disorders and their impact on MBD in hemodialysis patients. We have conducted an electronic literature research, where titles and abstracts of relevant papers were validated by the authors for further inclusion in this work. Finally, full texts of the included articles were retrieved. The findings of our literature research have concluded that at the age of 55, the relative risk of hip fractures increases and in CKD patients is high; after 4 years of undergoing dialysis, the age-specific relative risk of suffering a hip fracture was 9.83 for males and 8.10 for females. The average relative risk of mortality associated with hip fracture was 1.99. Our review has highlighted that CKD and MBD are closely related and they consist of a phenomenon requiring further research.