P0430 CASE REPORT: NEPHROTIC SYNDROME AS A CAUSE OF DEEP VEIN THROMBOSIS

and 30% of Intensive Care Unit admissions and it is associated with significant mortality and morbidity. Metabolic acidosis is one of the most important complications of acute renal failure as a result of accumulation of acids. Therefore, assessment of the ARF and its severity has to include arterial blood gases or venous bicarbonate measurement. Objectives: To determine whether serum bicarbonate is routinely measured, as a part of assessment of metabolic status in ARF occurring de novo or acute deterioration of CKD. Materials & methods: Retrospective, observational study of 92 random patients, presenting with acute or acute on CRF, managed by non-renal physicians on general medical wards. Serum creatinine and serum bicarbonate, including arterial and venous, was retrieved and data analysed. There are several definitions of ARF and for the purpose of this study we adopted the following criteria; ARF is defined by new onset elevation of serum creatinine of more than 200μmol/l (Normal range 60-120μmol/l) and acute deterioration of CKD defined as a rise in serum creatinine level of more than twice the previous stable creatinine readings. Results: 92 patients with a mean age of 68 years; female: male 48(52%): 44(48%) were studied. 59 patients had ARF and 33 had acute deterioration of CKD. Serum bicarbonate was measured in 15(25%) patients with ARF and 6(18%) patients with acute on chronic renal failure. Conclusion: In summary, only 21(23%) patients had serum bicarbonate measured as a part of initial evaluation of metabolic disturbances in renal failure. Measurement of bicarbonate level is prudent in the management process of renal failure, and indeed it is recognized as good clinical practice. This will help to assess the severity of the acidosis, and guide whether bicarbonate replacement and renal replacement therapy (RTT) is required, as presence of refractory acidaemia is an indication for RTT.