Acidosis: progression of chronic kidney disease and quality of life

Metabolic acidosis (MA) is relatively common in patients with chronic kidney disease (CKD) particularly in stages 4 and 5. It is assumed to play a contributory role in the development of several complications including bone disease, skeletal muscle wasting, altered protein synthesis, and degradation...

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Published in:Pediatric nephrology (Berlin, West) West), 2015-06, Vol.30 (6), p.873-879
Main Authors: de-Brito Ashurst, Ione, O’Lone, Emma, Kaushik, Tarun, McCafferty, Kieran, Yaqoob, Muhammad M.
Format: Article
Language:English
Subjects:
Acidosis
Acidosis - blood
Acidosis - drug therapy
Acidosis - etiology
Acidosis - psychology
Age Factors
Alkalies - adverse effects
Alkalies - therapeutic use
Amino acids
Ammonia
Analysis
Animals
Chronic kidney failure
Complications and side effects
Disease Progression
Humans
Hydrogen-Ion Concentration
Kidney diseases
Medicine
Medicine & Public Health
Metabolism
Nephrology
Pediatrics
Proteins
Quality of Life
Renal Insufficiency, Chronic - blood
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - drug therapy
Renal Insufficiency, Chronic - psychology
Review
Risk Factors
Rodents
Sodium
Sodium Bicarbonate - adverse effects
Sodium Bicarbonate - blood
Sodium Bicarbonate - therapeutic use
Treatment Outcome
Urology
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Summary:Metabolic acidosis (MA) is relatively common in patients with chronic kidney disease (CKD) particularly in stages 4 and 5. It is assumed to play a contributory role in the development of several complications including bone disease, skeletal muscle wasting, altered protein synthesis, and degradation. Recent evidence also suggests that even mild acidosis might play a role in progressive glomerular filtration rate loss. Experimental and clinical studies suggest that correction of acidosis by alkali therapy attenuates these complications and improves quality of life. Despite several recent small and single-center studies supporting this notion, more robust evidence is required with regard to the long-term benefits of alkali therapy, type of alkali supplements, and the optimal level of serum bicarbonate.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-014-2873-9