Acidosis related parameters in the acute renal failure patients diagnosed in the emergency department

Acute renal failure is one of the most common critical illnesses in the emergency department. Acidosis is a serious complication of acute renal failure. The aim of this study was to determine the parameters associated with acidosis in patients diagnosed with acute renal failure in the emergency department. Also we aimed to detect the threshold creatinine value for detecting the acidosis. This study has been conducted between November 2014 and February 2015 in the Emergency Department of Akdeniz University Hospital. Patients undergone a blood gas analysis secondary to acute renal failure were enrolled into the study. A total of 118 patients were included in the study. The mean age of the patients was 63.6±17 and 62 of them were male and 56, female. The univariate analysis revealed edema (p= 0.037), low bicarbonate levels (p= 0.001), BUN (p= 0.001), potassium levels (p= 0.0023), oxygen saturation in arterial blood gas (p= 0.04), chlorine level (p= 0.03) and creatinine level (p= 0.001) as significant. The logistic regression analysis revealed that HCO3 levels and oxygen levels in the blood gas analysis were the independent parameters in determining acidosis. ROC analysis showed that the creatinine levels of 1.45 mg/dL has a (-)LR of 0.0 (95% CI 91-100), a creatinine level of 1.55 has a (-)LR of 0.08 L (95% CI: 87.4 to 99.9) and a creatinine value of 3.6 has (+)LR of 3.3 (95% CI: 32-63). A bicarbonate level of 13.4 mEq/l has a (+)LR of 10.25 (95% CI 25.6 to 50.7) and 15.7 has a (+)LR of 5 (95% CI 43.3 to 74.4). A bicarbonate level of 27.8 has a (-)LR of 0.0 (95% CI 91.6 to 100%) and 25 has a (-)LR of 0.11 (95 CI: 87.4 to 99). Patients diagnosed with acute renal failure and who have a creatinine level of lower than 1.45 mg/dL does not need to undergo a blood gas analysis. Besides that, bicarbonate levels lower than 13.4 mEq/l should be considered as acidosis