Acidosis: progression of chronic kidney disease and quality of life
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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.
- 7.Bailey JL, Wang X, England BK, Price SR, Ding X, Mitch WE (1996) The acidosis of chronic renal failure activates muscle proteolysis in rats by augmenting transcription of genes encoding proteins of the ATP-dependent ubiquitin-proteasome pathway. J Clin Invest 97:1447–1453CrossRefPubMedCentralPubMedGoogle Scholar
- 11.Kooman JP, Deutz NE, Zijlmans P, Wall Bake A, Den A, Gerlag P, Van Hooff F, Leunissen K (1997) The influence of bicarbonate supplementation on plasma levels of branched chain amino acids in haemodialysis patients with metabolic acidosis. Nephrol Dial Transplant 12:2397–2401CrossRefPubMedGoogle Scholar
- 19.Throssel D, Brown J, Harris KP, Walls J (1995) Metabolic acidosis does not contribute to chronic renal injury in the rat. Clin Sci 89:643–650Google Scholar
- 33.KDOQI Work Group (2009) KDOQI clinical practice guideline for nutrition in children with CKD: 2008 update. Executive summary. Am J Kidney Dis 53 [3 Suppl 2]:S11–S104Google Scholar