Alkalization to retard progression of chronic kidney disease

Nimrit Goraya, Kalani L. Raphael, Donald E. Wesson

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations


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 languageEnglish (US)
Title of host publicationNutritional Management of Renal Disease, Fourth Edition
Number of pages13
ISBN (Electronic)9780128185407
ISBN (Print)9780128185414
StatePublished - Jan 1 2021


  • Acid
  • GFR
  • acidosis
  • alkali
  • bicarbonate
  • chronic kidney disease
  • diet

ASJC Scopus subject areas

  • Health Professions(all)
  • Medicine(all)


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