nach oben

International Urology and Nephrology

Erschienen in:

13.07.2020 | Nephrology - Review

Complications of metabolic acidosis and alkalinizing therapy in chronic kidney disease patients: a clinician-directed organ-specific primer

verfasst von: Sidar Copur, Alan A. Sag, Baris Afsar, Patrick Rossignol, Adrian Covic, Mehmet Kanbay

Erschienen in: International Urology and Nephrology | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Chronic kidney disease is prevalent, affecting more than one in ten adults. In this population, metabolic acidosis is considered a key underlying pathophysiological feature, tying together bone mineral disorders, sarcopenia, insulin resistance, vascular calcification, pro-inflammatory and pro-thrombotic states. This review aims to address the paucity of literature on alkalinizing agents, a promising treatment option that has known adverse effects.

Hill NR, Fatoba ST, Oke JL, Hirst JA, O'Callaghan CA, Lasserson DS et al (2016) Global prevalence of chronic kidney disease—a systematic review and meta-analysis. PLoS ONE 11(7):e0158765PubMedPubMedCentral

Mills KT, Xu Y, Zhang W, Bundy JD, Chen CS, Kelly TN et al (2015) A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney Int 88(5):950–957CrossRef

Zoccali C, Vanholder R, Massy ZA, Ortiz A, Sarafidis P, Dekker FW et al (2017) The systemic nature of CKD. Nat Rev Nephrol 13(6):344–358PubMed

Vanholder R, Fouque D, Glorieux G, Heine GH, Kanbay M, Mallamaci F et al (2016) Clinical management of the uraemic syndrome in chronic kidney disease. Lancet Diabetes Endocrinol 4(4):360–373PubMed

Kraut JA, Madias NE (2016) Metabolic acidosis of CKD: an update. Am J Kidney Dis 67(2):307–317PubMed

Abramowitz MK (2018) Metabolic acidosis and cardiovascular disease risk in CKD. Clin J Am Soc Nephrol 13(10):1451–1452PubMedPubMedCentral

Raphael KL (2019) Metabolic acidosis in CKD: core curriculum 2019. Am J Kidney Dis 74(2):263–275PubMed

Navaneethan SD, Shao J, Buysse J, Bushinsky DA (2019) Effects of treatment of metabolic acidosis in CKD: a systematic review and meta-analysis. Clin J Am Soc Nephrol 14(7):1011–1020PubMedPubMedCentral

Crimi E, Taccone FS, Infante T, Scolletta S, Crudele V, Napoli C (2012) Effects of intracellular acidosis on endothelial function: an overview. J Crit Care 27(2):108–118PubMed

10.

Goligorsky MS (2015) Pathogenesis of endothelial cell dysfunction in chronic kidney disease: a retrospective and what the future may hold. Kidney Res Clin Pract 34(2):76–82PubMedPubMedCentral

11.

Nath KA, Hostetter MK, Hostetter TH (1985) Pathophysiology of chronic tubulo-interstitial disease in rats. Interactions of dietary acid load, ammonia, and complement component C3. J Clin Invest. 76(2):667–675PubMedPubMedCentral

12.

Wesson DE, Simoni J, Broglio K, Sheather S (2011) Acid retention accompanies reduced GFR in humans and increases plasma levels of endothelin and aldosterone. Am J Physiol Renal Physiol 300(4):F830–F837PubMed

13.

Kanbay M, Afsar B, Siriopol D, Unal HU, Karaman M, Saglam M et al (2016) Relevance of uric acid and asymmetric dimethylarginine for modeling cardiovascular risk prediction in chronic kidney disease patients. Int Urol Nephrol 48(7):1129–1136PubMed

14.

Kanbay M, Yilmaz MI, Sonmez A, Turgut F, Saglam M, Cakir E et al (2011) Serum uric acid level and endothelial dysfunction in patients with nondiabetic chronic kidney disease. Am J Nephrol 33(4):298–304PubMedPubMedCentral

15.

Kanbay M, Afsar B, Gusbeth-Tatomir P, Covic A (2010) Arterial stiffness in dialysis patients: where are we now? Int Urol Nephrol 42(3):741–752PubMed

16.

Rossi GP, Seccia TM, Barton M, Danser AHJ, de Leeuw PW, Dhaun N et al (2018) Endothelial factors in the pathogenesis and treatment of chronic kidney disease Part I: general mechanisms: a joint consensus statement from the European Society of Hypertension Working Group on Endothelin and Endothelial Factors and The Japanese Society of Hypertension. J Hypertens 36(3):451–461PubMed

17.

Rossi GP, Seccia TM, Barton M, Danser AHJ, de Leeuw PW, Dhaun N et al (2018) Endothelial factors in the pathogenesis and treatment of chronic kidney disease Part II: role in disease conditions: a joint consensus statement from the European Society of Hypertension Working Group on Endothelin and Endothelial Factors and the Japanese Society of Hypertension. J Hypertens 36(3):462–471PubMed

18.

Perticone F, Maio R, Tripepi G, Zoccali C (2004) Endothelial dysfunction and mild renal insufficiency in essential hypertension. Circulation 110(7):821–825PubMed

19.

Mervaala E, Finckenberg P, Lapatto R, Müller DN, Park JK, Dechend R et al (2003) Lipoic acid supplementation prevents angiotensin II-induced renal injury. Kidney Int 64(2):501–508PubMed

20.

Himmelfarb J, Ikizler TA, Ellis C, Wu P, Shintani A, Dalal S et al (2014) Provision of antioxidant therapy in hemodialysis (PATH): a randomized clinical trial. J Am Soc Nephrol 25(3):623–633PubMed

21.

Kendrick J, Shah P, Andrews E, You Z, Nowak K, Pasch A et al (2018) Effect of treatment of metabolic acidosis on vascular endothelial function in patients with CKD: a pilot randomized cross-over study. Clin J Am Soc Nephrol CJASN 13(10):1463–1470PubMed

22.

Dubey AK, Sahoo J, Vairappan B, Haridasan S, Parameswaran S, Priyamvada PS (2020) Correction of metabolic acidosis improves muscle mass and renal function in chronic kidney disease stages 3 and 4: a randomized controlled trial. Nephrol Dial Transplant 35(1):121–129PubMed

23.

Sag AA, Covic A, London G, Vervloet M, Goldsmith D, Gorriz JL et al (2016) Clinical imaging of vascular disease in chronic kidney disease. Int Urol Nephrol 48(6):827–837PubMed

24.

Kanbay M, Vervloet M, Cozzolino M, Siriopol D, Covic A, Goldsmith D et al (2017) Novel faces of fibroblast growth factor 23 (FGF23): iron deficiency, inflammation, insulin resistance, left ventricular hypertrophy, proteinuria and acute kidney injury. Calcif Tissue Int 100(3):217–228PubMed

25.

Hénaut L, Chillon JM, Kamel S, Massy ZA (2018) Updates on the mechanisms and the care of cardiovascular calcification in chronic kidney disease. Semin Nephrol 38(3):233–250PubMed

26.

Kanbay M, Goldsmith D, Akcay A, Covic A (2009) Phosphate - the silent stealthy cardiorenal culprit in all stages of chronic kidney disease: a systematic review. Blood Purif 27(2):220–230PubMed

27.

Lang F, Leibrock C, Pelzl L, Gawaz M, Pieske B, Alesutan I et al (2018) therapeutic interference with vascular calcification-lessons from klotho-hypomorphic mice and beyond. Front Endocrinol (Lausanne) 9:207

28.

Zhang S, Xu J, Feng Y, Zhang J, Cui L, Zhang H et al (2018) Extracellular acidosis suppresses calcification of vascular smooth muscle cells by inhibiting calcium influx via L-type calcium channels. Clin Exp Hypertens 40(4):370–377PubMed

29.

Mendoza F, Lopez I, De Oca AM, Perez J, Rodriguez M, Aguilera-Tejero E (2008) Metabolic acidosis inhibits soft tissue calcification in uremic rats. Kidney Int 73(4):407–414PubMed

30.

Lomashvili K, Garg P, O’neill W (2006) Chemical and hormonal determinants of vascular calcification in vitro. Kidney Int 69(8):1464–1470PubMed

31.

Abramowitz MK (2017) Bicarbonate balance and prescription in ESRD. J Am Soc Nephrol 28(3):726–734PubMed

32.

Căpuşă C, Ştefan G, Stancu S, Lipan M, Tsur LD, Mircescu G (2017) Metabolic acidosis of chronic kidney disease and subclinical cardiovascular disease markers: friend or foe? Medicine (Baltimore) 96(47):e8802

33.

Aigner C, Cejka D, Sliber C, Fraunschiel M, Sunder-Plassmann G, Gaggl M (2019) Oral sodium bicarbonate supplementation does not affect serum calcification propensity in patients with chronic kidney disease and chronic metabolic acidosis. Kidney Blood Press Res 44(2):188–199PubMed

34.

Mitchell JH, Wildenthal K, Johnson RL Jr (1972) The effects of acid-base disturbances on cardiovascular and pulmonary function. Kidney Int 1(5):375–389PubMed

35.

Pedoto A, Caruso JE, Nandi J, Oler A, Hoffmann SP, Tassiopoulos AK et al (1999) Acidosis stimulates nitric oxide production and lung damage in rats. Am J Respir Crit Care Med 159(2):397–402PubMed

36.

Fernandes D, Assreuy J (2008) Nitric oxide and vascular reactivity in sepsis. Shock 30(Suppl 1):10–13PubMed

37.

Stancu S, Mircescu G, Mocanu A, Capusa C, Stefan G (2018) Metabolic acidosis of chronic kidney disease and cardiovascular disorders. Maedica 13(4):267–272PubMedPubMedCentral

38.

Taylor EN, Forman JP, Farwell WR (2007) Serum anion gap and blood pressure in the national health and nutrition examination survey. Hypertension 50(2):320–324PubMed

39.

Yilmaz MI, Solak Y, Covic A, Goldsmith D, Kanbay M (2011) Renal anemia of inflammation: the name is self-explanatory. Blood Purif 32(3):220–225PubMed

40.

Tripepi G, Mallamaci F, Zoccali C (2005) Inflammation markers, adhesion molecules, and all-cause and cardiovascular mortality in patients with ESRD: searching for the best risk marker by multivariate modeling. J Am Soc Nephrol 16(Suppl 1):S83–S88PubMed

41.

Honda H, Qureshi AR, Heimbürger O, Barany P, Wang K, Pecoits-Filho R et al (2006) Serum albumin, C-reactive protein, interleukin 6, and fetuin a as predictors of malnutrition, cardiovascular disease, and mortality in patients with ESRD. Am J Kidney Dis 47(1):139–148PubMed

42.

Gupta J, Mitra N, Kanetsky PA, Devaney J, Wing MR, Reilly M et al (2012) Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin J Am Soc Nephrol 7(12):1938–1946PubMedPubMedCentral

43.

Kanbay M, Onal EM, Afsar B, Dagel T, Yerlikaya A, Covic A et al (2018) The crosstalk of gut microbiota and chronic kidney disease: role of inflammation, proteinuria, hypertension, and diabetes mellitus. Int Urol Nephrol 50(8):1453–1466PubMed

44.

Onal EM, Afsar B, Covic A, Vaziri ND, Kanbay M (2019) Gut microbiota and inflammation in chronic kidney disease and their roles in the development of cardiovascular disease. Hypertens Res 42(2):123–140PubMed

45.

Ray SC, Baban B, Tucker MA, Seaton AJ, Chang KC, Mannon EC et al (2018) Oral NaHCO(3) activates a splenic anti-inflammatory pathway: evidence that cholinergic signals are transmitted via mesothelial cells. J Immunol 200(10):3568–3586PubMedPubMedCentral

46.

Ori Y, Zingerman B, Bergman M, Bessler H, Salman H (2015) The effect of sodium bicarbonate on cytokine secretion in CKD patients with metabolic acidosis. Biomed Pharmacother 71:98–101PubMed

47.

Isakova T, Wahl P, Vargas GS, Gutiérrez OM, Scialla J, Xie H et al (2011) Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int 79(12):1370–1378PubMedPubMedCentral

48.

Faul C, Amaral AP, Oskouei B, Hu MC, Sloan A, Isakova T et al (2011) FGF23 induces left ventricular hypertrophy. J Clin Invest 121(11):4393–4408PubMedPubMedCentral

49.

Melamed ML, Buttar RS, Coco M (2016) CKD-mineral bone disorder in stage 4 and 5 CKD: what we know today? Adv Chron Kidney Dis 23(4):262–269

50.

Muntner P, Jones TM, Hyre AD, Melamed ML, Alper A, Raggi P et al (2009) Association of serum intact parathyroid hormone with lower estimated glomerular filtration rate. Clin J Am Soc Nephrol 4(1):186–194PubMedPubMedCentral

51.

KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2009(113):S1–130

52.

Al-Haddad M, Khashab M, Zyromski N, Pungpapong S, Wallace MB, Scolapio J et al (2009) Risk factors for hyperechogenic pancreas on endoscopic ultrasound: a case-control study. Pancreas 38(6):672–675PubMed

53.

Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM (2004) Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol 15(8):2208–2218PubMed

54.

Levin A, Bakris GL, Molitch M, Smulders M, Tian J, Williams LA et al (2007) Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int 71(1):31–38PubMed

55.

de Boer IH, Katz R, Chonchol M, Ix JH, Sarnak MJ, Shlipak MG et al (2011) Serum 25-hydroxyvitamin D and change in estimated glomerular filtration rate. Clin J Am Soc Nephrol 6(9):2141–2149PubMedPubMedCentral

56.

Rebholz CM, Grams ME, Lutsey PL, Hoofnagle AN, Misialek JR, Inker LA et al (2016) Biomarkers of vitamin D status and risk of ESRD. Am J Kidney Dis 67(2):235–242PubMed

57.

Kandula P, Dobre M, Schold JD, Schreiber MJ Jr, Mehrotra R, Navaneethan SD (2011) Vitamin D supplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials. Clin J Am Soc Nephrol 6(1):50–62PubMedPubMedCentral

58.

Tamez H, Zoccali C, Packham D, Wenger J, Bhan I, Appelbaum E et al (2012) Vitamin D reduces left atrial volume in patients with left ventricular hypertrophy and chronic kidney disease. Am Heart J 164(6):902–9.e2PubMed

59.

Wang AY, Fang F, Chan J, Wen YY, Qing S, Chan IH et al (2014) Effect of paricalcitol on left ventricular mass and function in CKD—the OPERA trial. J Am Soc Nephrol 25(1):175–186PubMed

60.

Banerjee D, Chitalia N, Ster IC, Appelbaum E, Thadhani R, Kaski JC et al (2019) Impact of Vitamin D on Cardiac structure and function in CKD patients with hypovitaminosis D, a randomised controlled trial and meta-analysis. Eur Heart J Cardiovasc Pharmacother

61.

Thadhani R, Appelbaum E, Pritchett Y, Chang Y, Wenger J, Tamez H et al (2012) Vitamin D therapy and cardiac structure and function in patients with chronic kidney disease: the PRIMO randomized controlled trial. JAMA 307(7):674–684PubMed

62.

Charytan C, Coburn JW, Chonchol M, Herman J, Lien YH, Liu W et al (2005) Cinacalcet hydrochloride is an effective treatment for secondary hyperparathyroidism in patients with CKD not receiving dialysis. Am J Kidney Dis 46(1):58–67PubMed

63.

Chonchol M, Locatelli F, Abboud HE, Charytan C, de Francisco AL, Jolly S et al (2009) A randomized, double-blind, placebo-controlled study to assess the efficacy and safety of cinacalcet HCl in participants with CKD not receiving dialysis. Am J Kidney Dis 53(2):197–207PubMed

64.

Isakova T, Gutiérrez OM, Chang Y, Shah A, Tamez H, Smith K et al (2009) Phosphorus binders and survival on hemodialysis. J Am Soc Nephrol 20(2):388–396PubMedPubMedCentral

65.

Block GA, Wheeler DC, Persky MS, Kestenbaum B, Ketteler M, Spiegel DM et al (2012) Effects of phosphate binders in moderate CKD. J Am Soc Nephrol 23(8):1407–1415PubMedPubMedCentral

66.

Jamal SA, Vandermeer B, Raggi P, Mendelssohn DC, Chatterley T, Dorgan M et al (2013) Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Lancet 382(9900):1268–1277PubMed

67.

Krieger NS, Sessler NE, Bushinsky DA (1992) Acidosis inhibits osteoblastic and stimulates osteoclastic activity in vitro. Am J Physiol 262(3 Pt 2):F442–F448PubMed

68.

Kraut JA, Mishler DR, Singer FR, Goodman WG (1986) The effects of metabolic acidosis on bone formation and bone resorption in the rat. Kidney Int 30(5):694–700PubMed

69.

Kraut JA (2000) Disturbances of acid-base balance and bone disease in end-stage renal disease. Semin Dial 13(4):261–266PubMed

70.

Lin YF, Shieh SD, Diang LK, Lin SH, Chyr SH, Li BL et al (1994) Influence of rapid correction of metabolic acidosis on serum osteocalcin level in chronic renal failure. Asaio J 40(3):M440–M444PubMed

71.

Mathur RP, Dash SC, Gupta N, Prakash S, Saxena S, Bhowmik D (2006) Effects of correction of metabolic acidosis on blood urea and bone metabolism in patients with mild to moderate chronic kidney disease: a prospective randomized single blind controlled trial. Ren Fail 28(1):1–5PubMed

72.

McSherry E, Morris RC Jr (1978) Attainment and maintenance of normal stature with alkali therapy in infants and children with classic renal tubular acidosis. J Clin Invest 61(2):509–527PubMedPubMedCentral

73.

Sebastian A, Morris RC Jr (1994) Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 331(4):279PubMed

74.

Karet FE (2002) Inherited distal renal tubular acidosis. J Am Soc Nephrol 13(8):2178–2184PubMed

75.

Karunarathne S, Udayakumara Y, Govindapala D, Fernando H (2012) Medullary nephrocalcinosis, distal renal tubular acidosis and polycythaemia in a patient with nephrotic syndrome. BMC Nephrol 13(1):66PubMedPubMedCentral

76.

Both T, Zietse R, Hoorn EJ, van Hagen PM, Dalm VA, van Laar JA et al (2014) Everything you need to know about distal renal tubular acidosis in autoimmune disease. Rheumatol Int 34(8):1037–1045PubMedPubMedCentral

77.

Peter WLS, Wazny LD, Weinhandl E, Cardone KE, Hudson JQ (2017) A review of phosphate binders in chronic kidney disease: incremental progress or just higher costs? Drugs 77(11):1155–1186

78.

Suki WN, Zabaneh R, Cangiano J, Reed J, Fischer D, Garrett L et al (2007) Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients. Kidney Int 72(9):1130–1137PubMed

79.

Foley RN, Wang C, Ishani A, Collins AJ, Murray AM (2007) Kidney function and sarcopenia in the United States general population: NHANES III. Am J Nephrol 27(3):279–286PubMed

80.

Souza VA, Oliveira D, Mansur HN, Fernandes NM, Bastos MG (2015) Sarcopenia in chronic kidney disease. J Bras Nefrol 37(1):98–105PubMed

81.

Workeneh BT, Mitch WE (1128S) Review of muscle wasting associated with chronic kidney disease. Am J Clin Nutr 91(4):1128S–S1132PubMed

82.

Lai S, Muscaritoli M, Andreozzi P, Sgreccia A, De Leo S, Mazzaferro S et al (2019) Sarcopenia and cardiovascular risk indices in patients with chronic kidney disease on conservative and replacement therapy. Nutrition 62:108–114PubMed

83.

Abramowitz MK, Hostetter TH, Melamed ML (2011) Association of serum bicarbonate levels with gait speed and quadriceps strength in older adults. Am J Kidney Dis 58(1):29–38PubMedPubMedCentral

84.

Abramowitz MK, Hostetter TH, Melamed ML (2012) Lower serum bicarbonate and a higher anion gap are associated with lower cardiorespiratory fitness in young adults. Kidney Int 81(10):1033–1042PubMedPubMedCentral

85.

Wang XH, Mitch WE (2014) Mechanisms of muscle wasting in chronic kidney disease. Nat Rev Nephrol 10(9):504–516PubMedPubMedCentral

86.

Hamm LL (1999) Role of glucocorticoids in acidosis. Am J Kidney Dis 34(5):960–965PubMed

87.

Esche J, Shi L, Sánchez-Guijo A, Hartmann MF, Wudy SA, Remer T (2016) Higher diet-dependent renal acid load associates with higher glucocorticoid secretion and potentially bioactive free glucocorticoids in healthy children. Kidney Int 90(2):325–333PubMed

88.

Pickering WP, Price SR, Bircher G, Marinovic AC, Mitch WE, Walls J (2002) Nutrition in CAPD: serum bicarbonate and the ubiquitin-proteasome system in muscle. Kidney Int 61(4):1286–1292PubMed

89.

Stein A, Moorhouse J, Iles-Smith H, Baker F, Johnstone J, James G et al (1997) Role of an improvement in acid-base status and nutrition in CAPD patients. Kidney Int 52(4):1089–1095PubMed

90.

Verove C, Maisonneuve N, El Azouzi A, Boldron A, Azar R (2002) Effect of the correction of metabolic acidosis on nutritional status in elderly patients with chronic renal failure. J Renal Nutr 12(4):224–228

91.

de Brito-Ashurst I, Varagunam M, Raftery MJ, Yaqoob MM (2009) Bicarbonate supplementation slows progression of CKD and improves nutritional status. J Am Soc Nephrol 20(9):2075–2084PubMedPubMedCentral

92.

Abramowitz MK (2014) Acid-base balance and physical function. Clin J Am Soc Nephrol 9(12):2030–2032PubMedPubMedCentral

93.

Watson EL, Kosmadakis GC, Smith AC, Viana JL, Brown JR, Molyneux K et al (2013) Combined walking exercise and alkali therapy in patients with CKD4-5 regulates intramuscular free amino acid pools and ubiquitin E3 ligase expression. Eur J Appl Physiol 113(8):2111–2124PubMed

94.

Makanae Y, Fujita S (2015) Role of exercise and nutrition in the prevention of sarcopenia. J Nutr Sci Vitaminol 61(Supplement):S125–S127PubMed

95.

Maykish A, Sikalidis AK (2020) Utilization of hydroxyl-methyl butyrate, leucine, glutamine and arginine supplementation in nutritional management of sarcopenia—implications and clinical considerations for Type 2 diabetes mellitus risk modulation. J Person Med 10(1):19

96.

Fliser D, Pacini G, Engelleiter R, Kautzky-Willer A, Prager R, Franek E et al (1998) Insulin resistance and hyperinsulinemia are already present in patients with incipient renal disease. Kidney Int 53(5):1343–1347PubMed

97.

Spoto B, Pisano A, Zoccali C (2016) Insulin resistance in chronic kidney disease: a systematic review. Am J Physiol Renal Physiol 311(6):F1087–F1108PubMed

98.

Liao MT, Sung CC, Hung KC, Wu CC, Lo L, Lu KC (2012) Insulin resistance in patients with chronic kidney disease. J Biomed Biotechnol 2012:691369PubMedPubMedCentral

99.

Landau M, Kurella-Tamura M, Shlipak MG, Kanaya A, Strotmeyer E, Koster A et al (2011) Correlates of insulin resistance in older individuals with and without kidney disease. Nephrol Dial Transplant 26(9):2814–2819PubMedPubMedCentral

100.

Walker BG, Phear DN, Martin FI, Baird CW (1963) inhibition of insulin by acidosis. Lancet 2(7315):964–965PubMed

101.

Shechter Y, Ron A (1986) Effect of depletion of bicarbonate or phosphate ions on insulin action in rat adipocytes. Further characterization of the receptor-effector system. J Biol Chem. 261(32):14951–4PubMed

102.

Kobayashi S, Maesato K, Moriya H, Ohtake T, Ikeda T (2005) Insulin resistance in patients with chronic kidney disease. Am J Kidney Dis 45(2):275–280PubMed

103.

Kobayashi S, Maejima S, Ikeda T, Nagase M (2000) Impact of dialysis therapy on insulin resistance in end-stage renal disease: comparison of haemodialysis and continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 15(1):65–70PubMed

104.

Bellasi A, Di Micco L, Santoro D, Marzocco S, De Simone E, Cozzolino M et al (2016) Correction of metabolic acidosis improves insulin resistance in chronic kidney disease. BMC Nephrol 17(1):158PubMedPubMedCentral

105.

Chen W, Abramowitz MK (2014) Treatment of metabolic acidosis in patients with CKD. Am J Kidney Dis 63(2):311–317PubMed

106.

Mahajan A, Simoni J, Sheather SJ, Broglio KR, Rajab MH, Wesson DE (2010) Daily oral sodium bicarbonate preserves glomerular filtration rate by slowing its decline in early hypertensive nephropathy. Kidney Int 78(3):303–309PubMed

107.

Chen W, Abramowitz MK (2017) Epidemiology of acid-base derangements in CKD. Adv Chron Kidney Dis 24(5):280–288

108.

Kirschbaum B (2000) Spurious metabolic acidosis in hemodialysis patients. Am J Kidney Dis 35(6):1068–1071PubMed

109.

Goraya N, Simoni J, Jo CH, Wesson DE (2014) Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rate. Kidney Int 86(5):1031–1038PubMed

110.

Goraya N, Simoni J, Jo C, Wesson DE (2012) Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney Int 81(1):86–93PubMed

111.

Goraya N, Simoni J, Jo CH, Wesson DE (2013) A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clin J Am Soc Nephrol 8(3):371–381PubMedPubMedCentral

Titel: Complications of metabolic acidosis and alkalinizing therapy in chronic kidney disease patients: a clinician-directed organ-specific primer
verfasst von: Sidar Copur
Alan A. Sag
Baris Afsar
Patrick Rossignol
Adrian Covic
Mehmet Kanbay
Publikationsdatum: 13.07.2020
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 12/2020
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-020-02563-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2020

Reduced serum CTRP12 levels in type 2 diabetes are associated with renal dysfunction

Comparison of ischemic and ischemic/reperfused kidney injury via clamping renal artery, vein, or pedicle in anesthetized rats

Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups

Coercion, dissatisfaction, and social stigma: an ethnographic study of compensated living kidney donation in Iran

X-ray-free ultrasound-guided versus fluoroscopy-guided percutaneous nephrolithotomy: a comparative study with historical control