ASSOCIATION OF ACIDOSIS WITH LOSS OF MUSCLE STRENGTH IN CHRONIC HEMODIALYSIS PATIENTS

Abstract

Objective: To analyze the effect of acidosis, using bicarbonate levels, on muscle strength (FM) in patients with renal failure undergoing hemodialysis (HD). Methodology: This is a cross-sectional study in patients undergoing chronic HD at a dialysis clinic in Joinville, Santa Catarina, between March and July 2023. All patients aged between 18 and 65 years and with a dialysis duration of more than 3 months were included in the study. The values of bicarbonate, a variable of main interest, were analyzed using blood gas analysis. FM, the outcome variable, was evaluated using the Sit-to-Stand test and upper limb dynamometry. Clinical and laboratory variables and dialysis adequacy were also considered. The effect of the variable of interest on the outcome was evaluated using multivariate logistic regression in an explanatory model.  Results: Of the 90 patients, the mean age was 48.8 years, and 62.2% were male. Systemic arterial hypertension was found in 84.4% of the sample, followed by diabetes (24.4%) and stroke in 21.1%.  The presence of loss of strength was found in 24 (26.7%) patients. There was no difference in the median bicarbonate values between patients with or without loss of strength. Bicarbonate values were not associated with a higher risk of strength loss (crude OR = 0.94; 95% CI 0.78-1.13; p= 0.505). Even after adjusting for other confounding variables, bicarbonate levels were not associated with the outcome studied (adjusted OR=0.83; 95% CI 0.66-1.04; p=0.0012). Conclusion: In the sample studied, acidosis, verified by bicarbonate values, was not associated with FM loss.