{"id":24052,"date":"2024-05-30T15:27:00","date_gmt":"2024-05-30T19:27:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=24052"},"modified":"2026-05-25T15:34:03","modified_gmt":"2026-05-25T19:34:03","slug":"association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/","title":{"rendered":"Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the pre-dialysis serum bicarbonate concentration.<\/p>\n<p><strong>Objective<\/strong> \u2014 The objective is to examine the association between the dialysate bicarbonate prescription and the pre-dialysis serum bicarbonate concentration.<\/p>\n<p><strong>Design<\/strong> \u2014 This is a retrospective cohort study.<\/p>\n<p><strong>Setting<\/strong> \u2014 The study was performed using linked administrative health care databases in Ontario, Canada.<\/p>\n<p><strong>Patients<\/strong> \u2014 Prevalent adults receiving maintenance in-center hemodialysis as of April 1, 2020 (n = 5414) were included.<\/p>\n<p><strong>Measurements<\/strong> \u2014 Patients were grouped into the following dialysate bicarbonate categories at the dialysis center-level: individualized (adjustment based on pre-dialysis serum bicarbonate concentration) or standardized (&gt;90% of patients received the same dialysate bicarbonate concentration). The standardized category was stratified by concentration: 35, 36 to 37, and \u226538 mmol\/L. The primary outcome was the mean outpatient pre-dialysis serum bicarbonate concentration at the patient level.<\/p>\n<p><strong>Methods<\/strong> \u2014 We examined the association between dialysate bicarbonate category and pre-dialysis serum bicarbonate using an adjusted linear mixed model.<\/p>\n<p><strong>Results<\/strong> \u2014 All dialysate bicarbonate categories had a mean pre-dialysis serum bicarbonate concentration within the normal range. In the individualized category, 91% achieved a pre-dialysis serum bicarbonate \u226522 mmol\/L, compared to 87% in the standardized category. Patients in the standardized category tended to have a serum bicarbonate that was 0.25 (95% confidence interval [CI] = \u22120.93, 0.43) mmol\/L lower than patients in the individualized category. Relative to patients in the 35 mmol\/L category, patients in the 36 to 37 and \u226538 mmol\/L categories tended to have a serum bicarbonate that was 0.70 (95% CI = \u22120.30, 1.70) mmol\/L and 0.87 (95% CI = 0.14, 1.60) mmol\/L higher, respectively. There was no effect modification by age, sex, or history of chronic lung disease.<\/p>\n<p><strong>Limitations<\/strong> \u2014\u00a0We could not directly confirm that all laboratory measurements were pre-dialysis. Data on prescribed dialysate bicarbonate concentrations for individual dialysis sessions were not available, which may have led to some misclassification, and adherence to a practice of individualization could not be measured. Residual confounding is possible.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 We found no significant difference in the pre-dialysis serum bicarbonate concentration irrespective of whether an individualized or standardized dialysate bicarbonate was used. Dialysate bicarbonate concentrations \u226538 mmol\/L (vs 35 mmol\/L) may increase the pre-dialysis serum bicarbonate concentration by 0.9 mmol\/L.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the pre-dialysis serum bicarbonate concentration. Objective \u2014 The objective is to examine the association between the dialysate bicarbonate prescription and the pre-dialysis serum bicarbonate concentration. Design \u2014 This is a retrospective cohort study. Setting \u2014 [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[49,56],"migration-helper-qa-sample-set":[],"class_list":["post-24052","journal_article","type-journal_article","status-publish","hentry","topic-kidney-disease","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Molnar AO, Killin L, Bota S, McArthur E, Dixon SN, Garg AX, Harris C, Thompson S, Tennankore K, Blake PG, Bohm C, MacRae J, Silver SA. <em>Can J Kidney Health Dis<\/em>. 2024; 11:20543581241256774.","source_url":"https:\/\/doi.org\/10.1177\/20543581241256774","ices_scientist":[1316,1208,1242,1357],"site":[6739],"research_program":[6743],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study\" \/>\n<meta property=\"og:description\" content=\"Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2026-05-25T19:34:03+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\\\/\",\"name\":\"ICES | Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2024-05-30T19:27:00+00:00\",\"dateModified\":\"2026-05-25T19:34:03+00:00\",\"description\":\"Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study","description":"Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study","og_description":"Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2026-05-25T19:34:03+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/","name":"ICES | Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2024-05-30T19:27:00+00:00","dateModified":"2026-05-25T19:34:03+00:00","description":"Background \u2014 It is unclear whether the use of higher dialysate bicarbonate concentrations is associated with clinically relevant changes in the","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-the-dialysate-bicarbonate-and-the-pre-dialysis-serum-bicarbonate-concentration-in-maintenance-hemodialysis\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Association between the dialysate bicarbonate and the pre-dialysis serum bicarbonate concentration in maintenance hemodialysis: a retrospective cohort study"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/24052","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6743"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6739"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1357"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1242"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1208"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1316"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=24052"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=24052"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=24052"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=24052"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=24052"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}