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A basic solution for a complex problem: does treatment of metabolic acidosis slow CKD progression?
Kevin Bodker1, Natalie Freidin1, Nayan Arora2
1Medical University of South Carolina.
Current Opinion in Nephrology and Hypertension
|February 29, 2024
Summary
Routine treatment of metabolic acidosis in chronic kidney disease (CKD) patients is not supported by current evidence. Recent studies challenge earlier findings, suggesting alkali therapy may not slow CKD progression.
Area of Science:
- Nephrology
- Internal Medicine
- Clinical Practice Guidelines
Background:
- Metabolic acidosis is common in chronic kidney disease (CKD), with prevalence increasing as kidney function declines.
- Alkali therapy to normalize serum bicarbonate and slow CKD progression is a long-standing practice, based on animal models and controversial clinical trials.
Conclusions:
- The current literature does not support the routine treatment of metabolic acidosis in patients with CKD.
- Authors concur with upcoming KDIGO guidelines to de-emphasize this common practice.
- Further research may be needed to clarify the role of alkali therapy in specific CKD populations.
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