Basically, Dialysis Is Not Good Enough

[摘要] In CKD patients, the daily imbalance between endogenous acid production and renal acid excretion gradually leads to worsening metabolic acidosis. Although serum bicarbonate typically reaches a stable nadir, there is accumulating evidence that mild metabolic acidosis in late-stage CKD may cause adverse clinical outcomes. Specifically, several recent trials have focused on the relationship between metabolic acidosis and the rate of progression of CKD. The randomized controlled trial conducted by de Brito-Ashurst et al. demonstrated that sodium bicarbonate therapy slowed renal deterioration and improved nutritional outcomes (1). Another randomized trial comparing sodium bicarbonate to either sodium chloride or placebo showed that sodium bicarbonate slowed the decline in kidney function (2). Along with other supportive animal data indicating that alkalinization is renoprotective (3), there is now reasonable evidence that correction of metabolic acidosis may preserve residual kidney function.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome