Metabolic acidosis and kidney disease

Does bicarbonate therapy slow the progression of CKD?

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Metabolic acidosis is a common complication associated with progressive loss of kidney function. The diminishing ability of the kidneys to maintain acidbase homeostasis results in acid accumulation, leading to various complications such as impairment in nutritional status, worsened uremic bone disease and an association with increased mortality. In addition to these adverse effects which are related to acid retention, metabolic acidosis may also cause kidney damage, possibly through the stimulation of adaptive mechanisms aimed at maintaining acidbase homeostasis in the face of decreasing kidney function. Recent clinical trials have suggested that correction or prevention of metabolic acidosis by alkali administration is able to attenuate kidney damage and to slow progression of chronic kidney disease (CKD), and may hence offer an effective, safe and affordable renoprotective strategy. We review the physiology and pathophysiology of acidbase homeostasis in CKD, the mechanisms whereby metabolic acidosis may be deleterious to kidney function, and the results of clinical trials suggesting a benefit of alkali therapy, with special attention to details related to the practical implementation of the results of these trials.

Original languageEnglish (US)
Pages (from-to)3056-3062
Number of pages7
JournalNephrology Dialysis Transplantation
Volume27
Issue number8
DOIs
StatePublished - Aug 1 2012
Externally publishedYes

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Metabolic Diseases
Kidney Diseases
Bicarbonates
Acidosis
Chronic Renal Insufficiency
Kidney
Homeostasis
Alkalies
Therapeutics
Clinical Trials
Acids
Bone Diseases
Nutritional Status
Mortality

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Metabolic acidosis and kidney disease : Does bicarbonate therapy slow the progression of CKD? / Kovesdy, Csaba.

In: Nephrology Dialysis Transplantation, Vol. 27, No. 8, 01.08.2012, p. 3056-3062.

Research output: Contribution to journalArticle

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