The kidney plays critical roles in the human body. Chronic kidney diseases (CKD) have become a global epidemic and have been associated with increased risk of cardiovascular diseases, decreased quality of life, and high mortality rates. The role of the kidney in regulating body fluids makes it responsible for electrolyte and acid-base balance in the body. A common alteration that could occur due to renal disorders such as CKD is metabolic acidosis.
Metabolic acidosis is characterized by an excessive amount of acid in the body, which can occur in CKD patients due to the inability of the kidney to excrete enough acid from the body. In patients with CKD, metabolic acidosis occurs due to the kidney’s inability to excrete ammonia effectively, decreased reabsorption of bicarbonate at the distal convoluted tube level, and insufficient bicarbonate production. Additionally, the loss of most of the nephrons affects their base regeneration through the process of ammoniagenesis (Adamczak, et al., 2018).
In patients with CKD, alkali administration through the dietary intake of alkali precursors has been associated with decreased progression of renal diseases to CKD or more complicated forms of CKD (Dhondup & Qian, 2017). Some of the health implication associated with metabolic acidosis include demineralization of bones, muscle catabolism, and further deterioration of renal functions, which could lead to death (Raphael, 2018). Chronic metabolic acidosis has also been associated with increased protein breakdown, which leads to malnutrition-inflammation-atherosclerosis syndrome (Adamczak, et al., 2018). The negative effects of metabolic acidosis complicate the existing renal disorders in patients.
The negative effects of metabolic acidosis suggest the need for implementing proper management of CKD and other renal conditions as a way of preventing the occurrence of metabolic acidosis. Renal diseases should be treated to avoid complications.
Adamczak, M., Masajtis-Zagajewska, A., Mazanowska, O., Madziarska, K., Stompor, T., & Wiecek, A. (2018). Diagnosis and Treatment of metabolic acidosis in patients with chronic kidney disease – position statement of the working group of the Polish society of nephrology. Kidney & Blood Pressure Research, 43: 959-969. Retrieved from https://www.karger.com/Article/Fulltext/490475.
Dhondup, T., & Qian, Q. (2017). Acid-Base and electrolyte disorders in patients with and without chronic kidney disease: an update. Acid-Base, Electrolyte and Fluid Alterations: Review, 3: 136-148. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757582/pdf/kdd-0003-0136.pdf.
Raphael, K. L. (2018). Metabolic acidosis and subclinical metabolic acidosis in CKD. Journal of the American Society of Nephrology, 29(2), 376-382. Retrieved from https://jasn.asnjournals.org/content/29/2/376.