ABSTRACT
Despite major advances in renal replacement therapy over the last 20 years, mild to moderate metabolic acidosis remains a persistent finding in patients receiving dialysis treatments. In this chapter we review the evidence that acidosis has deleterious effects and then turn to the factors influencing acid-base homeostasis during peritoneal dialysis and hemodialysis. The final sections of the chapter are devoted to strategies to improve serum bicarbonate concentration in individuals([HCO ])3 receiving dialysis therapy and to providing guidelines for recognizing the presence of superimposed acid-base disturbances in this specialized population.
