Post-dialysis metabolic alkalosis can lead to a lower concentration of serum potassium due to intracellular shifting,29, -31 a longer corrected Q-T interval (which can increase the risk of cardiac arrhythmia),32 a higher drop in cardiac index33 during and post-dialysis, and more hypotension during dialysis.30 Other metabolic parameters affected by higher dialysate bicarbonate include lower ionized calcium32 and higher parathyroid hormone levels.34,35 Our study did not find any significant differences in pre-dialysis potassium or calcium. This evidence concerns the gene PTH and chronic obstructive pulmonary disease.