Acid Base Balance and Progression of Kidney Disease

Wei Chen; David S. Levy; Matthew K. Abramowitz

doi:10.1016/j.semnephrol.2019.04.009

Acid Base Balance and Progression of Kidney Disease

Wei Chen, David S. Levy, Matthew K. Abramowitz

Medicine

Research output: Contribution to journal › Review article › peer-review

21 Scopus citations

Abstract

Summary: A large body of work in animals and human beings supports the hypothesis that metabolic acidosis has a deleterious effect on the progression of kidney disease. Alkali therapy, whether pharmacologically or through dietary intervention, appears to slow CKD progression, but an appropriately powered randomized controlled trial with a low risk of bias is required to reach a more definitive conclusion. Recent work on urinary ammonium excretion has shown that the development of prognostic tools related to acidosis is not straightforward, and that application of urine markers such as ammonium may require more nuance than would be predicted based on our understanding of the pathophysiology.

Original language	English (US)
Pages (from-to)	406-417
Number of pages	12
Journal	Seminars in Nephrology
Volume	39
Issue number	4
DOIs	https://doi.org/10.1016/j.semnephrol.2019.04.009
State	Published - Jul 2019

Keywords

Renal insufficiency
acidosis
alkali therapy
alkalosis
chronic
kidney disease progression

ASJC Scopus subject areas

Nephrology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.semnephrol.2019.04.009

Cite this

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title = "Acid Base Balance and Progression of Kidney Disease",

abstract = "Summary: A large body of work in animals and human beings supports the hypothesis that metabolic acidosis has a deleterious effect on the progression of kidney disease. Alkali therapy, whether pharmacologically or through dietary intervention, appears to slow CKD progression, but an appropriately powered randomized controlled trial with a low risk of bias is required to reach a more definitive conclusion. Recent work on urinary ammonium excretion has shown that the development of prognostic tools related to acidosis is not straightforward, and that application of urine markers such as ammonium may require more nuance than would be predicted based on our understanding of the pathophysiology.",

keywords = "Renal insufficiency, acidosis, alkali therapy, alkalosis, chronic, kidney disease progression",

author = "Wei Chen and Levy, {David S.} and Abramowitz, {Matthew K.}",

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T1 - Acid Base Balance and Progression of Kidney Disease

AU - Chen, Wei

AU - Levy, David S.

AU - Abramowitz, Matthew K.

PY - 2019/7

Y1 - 2019/7

N2 - Summary: A large body of work in animals and human beings supports the hypothesis that metabolic acidosis has a deleterious effect on the progression of kidney disease. Alkali therapy, whether pharmacologically or through dietary intervention, appears to slow CKD progression, but an appropriately powered randomized controlled trial with a low risk of bias is required to reach a more definitive conclusion. Recent work on urinary ammonium excretion has shown that the development of prognostic tools related to acidosis is not straightforward, and that application of urine markers such as ammonium may require more nuance than would be predicted based on our understanding of the pathophysiology.

AB - Summary: A large body of work in animals and human beings supports the hypothesis that metabolic acidosis has a deleterious effect on the progression of kidney disease. Alkali therapy, whether pharmacologically or through dietary intervention, appears to slow CKD progression, but an appropriately powered randomized controlled trial with a low risk of bias is required to reach a more definitive conclusion. Recent work on urinary ammonium excretion has shown that the development of prognostic tools related to acidosis is not straightforward, and that application of urine markers such as ammonium may require more nuance than would be predicted based on our understanding of the pathophysiology.

KW - Renal insufficiency

KW - acidosis

KW - alkali therapy

KW - alkalosis

KW - chronic

KW - kidney disease progression

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M3 - Review article

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AN - SCOPUS:85068533554

SN - 0270-9295

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JO - Seminars in Nephrology

JF - Seminars in Nephrology

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ER -

Acid Base Balance and Progression of Kidney Disease

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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