• Justin J Hourmozdi, Jasreen Gill, Joseph B Miller, Abraham Markin, Beth Adams, Vivek Soi, Anja K Jaehne, Andrew R Taylor, Sam Langberg, Lauren Rodriguez, Carynne Fox, Junior Uduman, Lenar T Yessayan, and Emanuel P Rivers.
• Department of Emergency Medicine, Henry Ford Hospital, Wayne State University, Detroit, MI. Electronic address: jhourmoz@icloud.com.
• Ann Emerg Med. 2018 Jun 1; 71 (6): 737-742.

Study ObjectivePatients with end-stage renal disease commonly visit the emergency department (ED). The purpose of this investigation is to examine the prevalence of baseline abnormal lactate levels and to evaluate the effects of hemodialysis on serum lactate levels.MethodsThis was a prospective observational cohort study performed at an outpatient dialysis facility at an urban tertiary care hospital. The study consisted of 226 patients with end-stage renal disease who were receiving long-term hemodialysis and were enrolled during a 2-day period at the beginning of December 2015. Blood drawn for lactate levels was immediately analyzed before and after hemodialysis sessions. All patients completed their hemodialysis sessions.ResultsThe prevalence of an abnormal lactate level (greater than 1.8 mmol/L) before hemodialysis was 17.7% (n=40). Overall, lactate levels decreased by 27% (SD 35%) after hemodialysis, with a decrease of 37% (SD 31%) for subgroups with a lactate level of 1.9 to 2.4 mmol/L, and 62% (SD 14%) with a lactate of 2.5 to 3.9 mmol/L.ConclusionThe data presented help providers understand the prevalence of abnormal lactate values in an outpatient end-stage renal disease population. After hemodialysis, lactate levels decreased significantly. This information may help medical providers interpret lactate values when patients with end-stage renal disease present to the ED.Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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