title: Metabolic acidosis and progression of chronic kidney disease: incidence, pathogenesis, and therapeutic options.
abstract: In the chronic kidney disease population metabolic acidosis is prevalent presenting already in the early stages of renal dysfunction. The pathogenesis associates the lack of bicarbonate production with the accumulation of organic/inorganic acids and the development of tubulointerstitial damage through ammonium retention and complement deposition. The empiric use of oral sodium bicarbonate represents an interesting therapeutic option that has been documented in a few clinical trials in human subjects. The availability of oral sodium, in its diverse forms, represents an inexpensive and simple way of treating an entity that could hasten the progression of kidney disease, as well as protein catabolism, bone disease and mortality.
authors.affiliation: Nephrology and Hypertension, Allegheny General Hosptial, WPAHS, Temple University School of Medicine, 320 East North Ave Pittsburgh Pa, 15212-4772, Pittsburgh, Pennsylvania, USA. lortega@wpahs.org
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ortega
authors.forename: Swati
authors.initials: S
authors.lastname: Arora
mesh_terms: D000138:Acidosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D000818:Animals; D018450:Disease Progression; D006801:Humans; D015994:Incidence; D051436:Renal Insufficiency, Chronic / Q000150:complications*