Progression of chronic kidney disease (CKD) contributes to increasing end-stage kidney disease and so addressing factors that mediate CKD progression is an important investigative focus. Evolving studies support a spectrum of “acid (H+) stress” beyond metabolic acidosis that includes pathologic acid (H+) accumulation without changes in plasma acid–base parameters reflective of metabolic acidosis. The full spectrum of H+ stress prior to its manifestation as metabolic acidosis appears to cause kidney injury and progressive CKD. Recent studies support that alkali therapy done with diet and/or pharmacologically ameliorates H+ stress and retards CKD progression. This chapter discusses potential mechanisms for H+ stress–induced CKD progression and strategies by which clinicians can execute such alkali therapy.
|Original language||English (US)|
|Title of host publication||Nutritional Management of Renal Disease, Fourth Edition|
|Number of pages||13|
|State||Published - Jan 1 2021|
- chronic kidney disease
ASJC Scopus subject areas
- Health Professions(all)