Victoria Socha

DocwireNews

One of the key functions of the kidney is 
maintenance of normal acid-base homeostasis. In patients with chronic kidney 
disease (CKD), the capacity of the kidneys to excrete the daily acid load as 
ammonium and titratable acid is compromised. The result is acid retention and 
metabolic acidosis.There is an association between declining 
estimated glomerular filtration rate and the prevalence of metabolic acidosis. 
Metabolic acidosis is associated with various clinical complications, including 
progression of CKD, bone demineralization, skeletal muscle catabolism, and 
mortality. Clinical guidelines suggest treating metabolic acidosis with oral 
alkali in patients with CKD to mitigate those adverse consequences.However, there are few data available on the 
efficacy and safety of correcting metabolic acidosis with oral alkali in that 
patient population. In 2019, Kalani L. Rapheal, MD, described a Core 
Curriculum for treating patients with CKD and metabolic acidosis in an article 
published in the American Journal of Kidney Diseases 
[2019;74(2):263-275]. The article discussed established and emerging concepts 
regarding regulating kidney acid-base regulation<ins>,</ins> as 
well as the pathogenesis, risk factors, diagnosis, and management of metabolic 
acidosis in CKD.

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Management of Metabolic Acidosis in CKD: Core Curriculum 2019

Chronic Kidney Disease

In patients with chronic kidney disease (CKD), the capacity of the kidneys to excrete the daily acid load as ammonium and titratable acid is compromised. 

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