TY - JOUR
T1 - The clinical spectrum of chronic metabolic acidosis
T2 - Homeostatic mechanisms produce significant morbidity
AU - Alpern, Robert J.
AU - Sakhaee, Khashayar
N1 - Funding Information:
From the Department of Internal Medicine, University Texas Southwestern Medical Center, Dallas, TX. Received May 28, 1996; accepted in revised form September 3, 1996. Supported by National Institutes of Health Grants No. R37-DK39298 and POl-DK20543. Address reprint requests to Robert J. Alpem, MD, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-8856. 0 1997 by the National Kidney Foundation, 0272~6386/97f2902-0019$3.00/O
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1997/2
Y1 - 1997/2
N2 - Chronic metabolic acidosis is a process whereby an excess nonvolatile acid load is chronically placed on the body due to excess acid generation or diminished acid removal by normal homeostatic mechanisms. Two common, often- overlooked clinical conditions associated with chronic metabolic acidosis are aging and excessive meat ingestion. Because the body's homeostatic response to these pathologic processes is very efficient, the serum HCO3 - and blood pH are frequently maintained within the 'normal' range. Nevertheless, these homeostatic responses engender pathologic consequences, such as nephrolithiasis, bone demineralization, muscle protein breakdown, and renal growth. Based on this, the concept of eubicarbonatemic metabolic acidosis is introduced. Even in patients with a normal serum HCO3 - and blood pH, it is important to treat the acid load and prevent pathologic homeostatic responses. These homeostatic responses, as well as the mechanisms responsible for their initiation, are reviewed.
AB - Chronic metabolic acidosis is a process whereby an excess nonvolatile acid load is chronically placed on the body due to excess acid generation or diminished acid removal by normal homeostatic mechanisms. Two common, often- overlooked clinical conditions associated with chronic metabolic acidosis are aging and excessive meat ingestion. Because the body's homeostatic response to these pathologic processes is very efficient, the serum HCO3 - and blood pH are frequently maintained within the 'normal' range. Nevertheless, these homeostatic responses engender pathologic consequences, such as nephrolithiasis, bone demineralization, muscle protein breakdown, and renal growth. Based on this, the concept of eubicarbonatemic metabolic acidosis is introduced. Even in patients with a normal serum HCO3 - and blood pH, it is important to treat the acid load and prevent pathologic homeostatic responses. These homeostatic responses, as well as the mechanisms responsible for their initiation, are reviewed.
KW - Citrate
KW - bone
KW - c-src
KW - muscle catabolism
KW - nephrolithiasis
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U2 - 10.1016/S0272-6386(97)90045-7
DO - 10.1016/S0272-6386(97)90045-7
M3 - Article
C2 - 9016905
AN - SCOPUS:0030891508
VL - 29
SP - 291
EP - 302
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 2
ER -