Abstract
Aim: To evaluate the role of strong ion difference (SID) in acid-base disorders in patients with liver disease. Patients and methods: We evaluated the acid-base status in 11 patients with liver cirrhosis both by traditional and quantitative Stewart-Fencl methods.
Results: Nine of eleven patients had pH within the norm, 2/11 had pH above 7.44. One patient had respiratory alkalosis, the second had a combined respiratory alkalemia and metabolic acidemia.
The anion gap was increased only in one patient, but after correction for serum albumin concentration, it was above the norm in 10/11 patients. pCO2 was below the normal limit in 5/11 patients. The Stewart-Fencl evaluation revealed decreased SID in 11/11 patients.
Both SID and the difference in [Na+] - [Cl-] closely correlated with [HCO3-] (r = 0.9264 and r = 0.7272, respectively, P < 0.01). The not routinely assayed ions [UA-] were increased in 9/11 patients.
Conclusion: The acid-base status in patients with decompensated liver cirrhosis was characterized by a tend-ency to respiratory alkalemia and metabolic acidemia. Apart from an increase of [UA-], the difference in [Na+] - [Cl-] con-tributed significantly to acidemia.
Thus, this simple parameter aids in determining the causes of acid-base disturbance and influences the treatment strategy.