Metabolic Acidosis in Patients with CKD: Epidemiology, Pathogenesis, and Treatment

被引:33
作者
Adamczak, Marcin [1 ]
Surma, Stanislaw [1 ]
机构
[1] Med Univ Silesia, Dept Nephrol Transplantat & Internal Med, Katowice, Poland
关键词
Metabolic acidosis; Chronic kidney disease; Sodium bicarbonate; Veverimer; CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; SERUM BICARBONATE; SODIUM-BICARBONATE; BLOOD-PRESSURE; ELECTROLYTE HOMEOSTASIS; INSULIN-RESISTANCE; LOAD; PROGRESSION; CHLORIDE;
D O I
10.1159/000516371
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Metabolic acidosis in CKD is diagnosed in patients with plasma or venous blood bicarbonate concentration lower than 22 mmol/L. Metabolic acidosis occurs in about 20% of patients with CKD. Metabolic acidosis may lead to dysfunction of many systems and organs as well as CKD progression. Currently, sodium bicarbonate is mainly used for pharmacological treatment of metabolic acidosis in patients with CKD. Veverimer is a new drug dedicated to treatment of metabolic acidosis in patients with CKD. Orally given veverimer binds hydrogen ions in the intestines and subsequently is excreted from the body with feces. Clinical studies have shown that veverimer is effective in increasing serum bicarbonate concentrations in CKD patients with metabolic acidosis. Here, we present review of the epidemiology, pathogenesis, diagnosis, treatment, and prevention of metabolic acidosis in CKD patients. Summary: Metabolic acidosis is common in patients with CKD and contributes to CKD progression and many complications, which worsen the prognosis in these patients. Currently, sodium bicarbonate is mainly used in metabolic acidosis treatment. The role of the new drug veverimer in the metabolic acidosis therapy needs further studies. Key Message: The aim of this review article is to summarize the current knowledge concerning the epidemiology, pathogenesis, diagnosis, treatment, and prevention of metabolic acidosis in CKD patients.
引用
收藏
页码:452 / 467
页数:16
相关论文
共 86 条
[1]   Diagnosis and Treatment of Metabolic Acidosis in Patients with Chronic Kidney Disease - Position Statement of the Working Group of the Polish Society of Nephrology [J].
Adamczak, Marcin ;
Masajtis-Zagajewska, Anna ;
Mazanowska, Oktawia ;
Madziarska, Katarzyna ;
Stompor, Tomasz ;
Wiecek, Andrzej .
KIDNEY & BLOOD PRESSURE RESEARCH, 2018, 43 (03) :959-969
[2]   Veverimer: An Emerging Potential Treatment Option for Managing the Metabolic Acidosis of CKD [J].
Adrogue, Horacio J. ;
Madias, Nicolaos E. .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2020, 76 (06) :861-867
[3]   A study on effect of bicarbonate supplementation on the progression of chronic kidney disease [J].
Alva, Suhan ;
Divyashree, M. ;
Kamath, Janardhana ;
Prakash, P. S. ;
Prakash, Shama K. .
INDIAN JOURNAL OF NEPHROLOGY, 2020, 30 (02) :91-97
[4]   Mechanisms of Anemia in CKD [J].
Babitt, Jodie L. ;
Lin, Herbert Y. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2012, 23 (10) :1631-1634
[5]   Correction of metabolic acidosis improves insulin resistance in chronic kidney disease [J].
Bellasi, Antonio ;
Di Micco, Lucia ;
Santoro, Domenico ;
Marzocco, Stefania ;
De Simone, Emanuele ;
Cozzolino, Mario ;
Di Lullo, Luca ;
Guastaferro, Pasquale ;
Di Iorio, Biagio .
BMC NEPHROLOGY, 2016, 17
[6]   Low environmental pH is responsible for the induction of nitric-oxide synthase in macrophages -: Evidence for involvement of nuclear factor-κB activation [J].
Bellocq, A ;
Suberville, S ;
Philippe, C ;
Bertrand, F ;
Perez, J ;
Fouqueray, B ;
Cherqui, G ;
Baud, L .
JOURNAL OF BIOLOGICAL CHEMISTRY, 1998, 273 (09) :5086-5092
[7]   Epidemiology of hyperkalemia in chronic kidney disease [J].
Belmar Vega, Lara ;
Rodrigo Galabia, Emilio ;
Bada da Silva, Jairo ;
Bentanachs Gonzalez, Marta ;
Fernandez Fresnedo, Gema ;
Pinera Haces, Celestino ;
Palomar Fontanet, Rosa ;
Ruiz San Millan, Juan Carlos ;
Martin de Francisco, Angel Luis .
NEFROLOGIA, 2019, 39 (03) :277-286
[8]   Effect of chronic metabolic acidosis on the growth hormone IGF-1 endocrine axis: New cause of growth hormone insensitivity in humans [J].
Brungger, M ;
Hulter, HN ;
Krapf, R .
KIDNEY INTERNATIONAL, 1997, 51 (01) :216-221
[9]   Randomized, Controlled Trial of TRC101 to Increase Serum Bicarbonate in Patients with CKD [J].
Bushinsky, David A. ;
Hostetter, Thomas ;
Klaerner, Gerrit ;
Stasiv, Yuri ;
Lockey, Claire ;
McNulty, Sarah ;
Lee, Angela ;
Parsell, Dawn ;
Mathur, Vandana ;
Li, Elizabeth ;
Buysse, Jerry ;
Alpern, Robert .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2018, 13 (01) :26-35
[10]   A Low Serum Bicarbonate Concentration as a Risk Factor for Mortality in Peritoneal Dialysis Patients [J].
Chang, Tae Ik ;
Oh, Hyung Jung ;
Kang, Ea Wha ;
Yoo, Tae-Hyun ;
Shin, Sug Kyun ;
Kang, Shin-Wook ;
Choi, Kyu Hun ;
Han, Dae Suk ;
Han, Seung Hyeok .
PLOS ONE, 2013, 8 (12)