Abstract

Background and objective Metabolic acidosis is a common metabolic complication of chronic kidney disease with different frequencies across stages of CKD. The objective of the study was to estimate the prevalence and study predictors for development of severe metabolic acidosis in CKD stage 3-5.
Methods It was a cross-sectional study of patients aged > 18 years with metabolic acidosis and stage 3-5 CKD for 1 year at two medical centers in Iraq. The prevalence of severe metabolic acidosis and correlation with patients’ characteristics were studied using Fisher exact test for categorical variables and nonparametric independent samples Mann-Whitney U T test. Predictors for severe metabolic acidosis was analyzed using multiple logistic regression.
Results Among 117 patients with CKD stage 3-5 and metabolic acidosis, severe metabolic acidosis was reported in 14.5%. It was more frequent in stage 5 CKD compared to stage 4 CKD (64.7% vs 35.3%). Correlation of severe metabolic acidosis was statistically significant with urinary tract obstruction, glomerular diseases, reduced cortical thickness on ultrasonography, anemia, hyperkalemia, hypocalcemia and hyperphosphatemia. By multivariate analysis, female sex, urinary tract obstruction and glomerular diseases were predictors for development of severe metabolic acidosis.
Conclusion Severe metabolic acidosis was common in stage 5 CKD. Female sex, urinary tract obstruction and glomerular diseases were predictors for development of severe metabolic acidosis.