الفهرس 
Introduction
Acidosis in chronic renal failureOnly 14 pages are availabe for public view
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Abstract
ESRD patients on regular hemodialysis are prone to have Intradialytic hypotension. Intradialytic hypotension is associated with undesirable symptoms such as abdominal discomfort, yawning, sighing, nausea, vomiting, muscle cramps, restlessness, dizziness, fainting, anxiety, and others. Intradialytic hypotension occurs more frequently in non-compliant patients, especially with too high inter-dialytic fluid intake, as well as in persons eating just before or during dialysis sessions.
Efficient treatment of Intradialytic hypotension is still a great challenge.Adequate therapy is difficult and requires a multilevel strategy.
Metabolic acidosis of end stage renal patients could be successfully corrected with bicarbonate hemodialysis. Bicarbonate dialysate is a safe, well-tolerated and useful tool for better correction of the metabolic acidosis.
During the hemodialysis (HD) process, prominent changes occur in serum electrolyte and bicarbonate levels due to electrolyte shift across the dialyzer membrane. Rapid electrolyte changes may have important consequences such as arrhythmia and sudden cardiac death.
Although there are many studies that have been studyingthe effects of correction of acidosis on protein degradation and nutritional status, and also there is many studies that have been studying the cardiopulmonary events can occur frequently during hemodialysis, and the frequency is dependent on the dialysate buffer used (acetate or bicarbonate), and also studying hemodynamic consequences of changing bicarbonate concentrations in haemodialysis fluids, there is no previous study thatanalyze if there is a relation between the intradialytic changes of serum bicarbonate level and hemodynamics instability forms that occurred during correction of metabolic acidosis in prevalent hemodialysis patients.
This study was prospective study conducted upon 40 ESRD patients on regular hemodialysis three times per week four hours each session in the Hemodialysis Unit in Al-Agouza Hospital.
In this study all patients measure systolic and diastolic blood pressure and heart rate before starting the session, every 30 min. through-out the dialysis and at the end of the session using sphygmomanometer, whole blood pH and serum bicarbonate level was measured at the beginning, after 2 hours, and at the end of the session.Total serum calcium, sodium, potassium level were measured at beginning, and at the end of the session.
We observed that mean arterial blood pressure decreased during the hemodialysis, as a result of correction of metabolic acidosis by bicarbonate dialysate, as well as changes in heart rate occurred at the end of the session.
Also we found that there is statistical significant inverse correlation between mean arterial blood pressure at the end of the session and interdialytic weight gain.
Also we observed there is no correlation between changes that occurred in mean arterial blood pressure and mean of heart rate for all cases.
In conclusion our study finds that metabolic alkalosis induced by bicarbonate transferred from the bicarbonate dialysate lead to hypotension during the dialysisat the same sodium profiling and the same blood temperature, as well as increased interdialytic weight gain lead to hypotension at the end of the session.