Treatment of metabolic acidosis in patients with CKD.
Metabolic acidosis is a common complication of chronic kidney disease and is believed to contribute to a number of sequelae, including bone disease, altered protein metabolism, skeletal muscle wasting, and progressive glomerular filtration rate loss. Small trials in animal models and humans suggest a role for alkali therapy to lessen these complications. Recent studies support this notion, although more definitive evidence is needed on the long-term benefits of alkali therapy and the optimal serum bicarbonate level. The role of dietary modification also should be given greater consideration. In addition, potential adverse effects of alkali treatment must be taken into consideration, including sodium retention and the theoretical concern of promoting vascular calcification. This teaching case summarizes the rationale for and benefits and complications of base therapy in patients with chronic kidney disease.
Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
Wei
W
Chen
Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY. Electronic address: matthew.abramowitz@einstein.yu.edu.
Matthew K
MK
Abramowitz
D000138:Acidosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D000818:Animals; D005247:Feeding Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
Metabolic acidosis; alkali therapy; bicarbonate; chronic kidney disease