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The Influence of Graded Degrees of Chronic Renal Failure

Blaise Widmer, MD; Robert E. Gerhardt, MD; John T. Harrington, MD; Jordan J. Cohen, MD

Arch Intern Med. 1979;139(10):1099-1102.

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 tCO₂ was 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 tCO₂ occurred that were proportional to the increment in serum creatinine. These latter decrements in tCO₂ were associated with equivalent increments in A-, serum Cl-- remaining unchanged at the elevated level observed during moderate renal insufficiency. Confidence limits of 95% for tCO₂ and A were calculated from the data.

(Arch Intern Med 139:1099-1102, 1979)

Author Affiliations
From the Renal Service, Tufts-New England Medical Center, and the Department of Medicine, Tufts University School of Medicine, Boston.

Footnotes
Accepted for publication March 6, 1979.

Reprint requests to New England Medical Center Hospital, 171 Harrison Ave, Boston, MA 02111 (Dr Cohen).

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