Dialysis and Acid-Base Balance: A Comparative Physiological Analysis of Boston and Stewart Models.

ABSTRACT: Background: The relative merits of the Henderson-Hasselbalch (HH) versus Stewart frameworks for interpreting dialysis-associated acid-base shifts remain debated. Dialysis alters systemic pH through exogenous bicarbonate delivery, chloride displacement, and removal of organic anions. We compared these approaches across hemodialysis (HD) and peritoneal dialysis (PD). Methods: We studied 53 HD patients with paired pre/post-HD blood gas and chemistry (106 observations) and 41 PD patients cross-sectionally, totaling 147 datasets. Derived variables followed the Figge/Stewart implementation [apparent SID (SIDa), effective SID (SIDe), strong ion gap (SIG), albumin-corrected anion gap (AGc)]. For HD, changes in pH (ΔpH) were modeled using HH predictors (ΔHCO₃^-, Δ

SUBMITTER: Kroustalakis N 

PROVIDER: S-EPMC12653126 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature