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Does correction of metabolic acidosis slow chronic kidney disease progression?

Goraya, Nimrita,b; Wesson, Donald E.a,b

Current Opinion in Nephrology and Hypertension: March 2013 - Volume 22 - Issue 2 - p 193–197
doi: 10.1097/MNH.0b013e32835dcbbe
CLINICAL NEPHROLOGY: Edited by Bradley M. Denker
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Purpose of review Most patients with chronic kidney disease (CKD) have progressive decline in glomerular filtration rate (GFR), despite current treatment practices. Recent studies support that dietary acid reduction with oral sodium based alkali or base-inducing food types add kidney protection to that provided by current kidney-protective interventions. Related studies also support that correction of metabolic acidosis with dietary acid reduction slows CKD progression. We reviewed these recent studies that show improvement in CKD parameters and slower CKD progression in response to improvement of CKD-associated metabolic acidosis with these interventions.

Recent findings Animal as well as human models of CKD show that alkali treatment ameliorates indices of kidney injury and also might slow GFR decline in patients with or without metabolic acidosis. These benefits have been similar with oral sodium-based alkali and base-inducing fruits and vegetables, supporting dietary acid reduction as an effective adjunct to conventional kidney-protective interventions.

Summary Recent studies suggest that metabolic acidosis mediates nephropathy progression, and its treatment with the comparatively inexpensive and well tolerated intervention of dietary acid reduction holds promise to be an additional kidney-protective strategy in CKD management.

aTexas A&M College of Medicine

bScott and White Healthcare, Department of Internal Medicine, Temple, Texas, USA

Correspondence to Donald E. Wesson, MD, Texas A&M College of Medicine, Scott and White Healthcare, 2401 South 31st Street, Temple, TX 76508, USA. Tel: +1 254 724 2368; fax: +1 254 724 7113; e-mail: dwesson@sw.org

© 2013 Lippincott Williams & Wilkins, Inc.