Journal Information
Vol. 32. Issue. 6.November 2012
Pages 701-866
Vol. 32. Issue. 6.November 2012
Pages 701-866
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Acidosis metabólica y avance de la enfermedad renal crónica: incidencia, patogénesis y opciones terapéuticas
Metabolic acidosis and progression of chronic kidney disease: incidence, pathogenesis, and therapeutic options
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WPAHS Division of Nephrology and Hypertension. Allegheny General Hospital, WPAHS, Temple University School of Medicinea, wpahs division of nephrology and hypertension Allegheny general hospital, wpahs, temple university school of medicineb, Luis M. Ortegac, luis M Ortegad, Swati Arorad
a Allegheny General Hospital, Pittsburgh, Pennsylvania, USA,
b nephrology and hypertension, allegheny general hospital, pittsburgh, pennsylvania, USA,
c Nephrology and Hypertension, Allegheny General Hospital. WPAHS, Temple University School of Medicine, Pittsburgh, Pennsylvania, USA,
d nephrology and hypertension, Allegheny general hosptial.WPAHS,Temple University School of Medicine, Pittsburgh, Pennsylvania, USA,
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Article information

Hay una prevalencia importante de la acidosis metabólica en los pacientes que padecen enfermedad renal crónica, presentándose en niveles tempranos de pérdida de filtrado glomerular. La patogénesis se basa en la falta de síntesis de bicarbonato sérico con la acumulación de ácidos de naturaleza orgánica e inorgánica, ocasionando daño tubulointersticial a través de la retención de amoniaco y el depósito de complemento, aunque esta última hipótesis se ha cuestionado en el pasado. El uso empírico de bicarbonato oral representa una opción terapéutica interesante que ha sido utilizada en estudios clínicos recientes. La disponibilidad de bicarbonato de sodio oral en sus diversas formas representa una opción barata y simple de utilizar para decelerar la progresión de la enfermedad renal, sin mencionar las mejoras en el catabolismo proteico, la osteodistrofia renal y la mortalidad.

Palabras clave:
Amoniaco
Palabras clave:
Bicarbonato sódico
Palabras clave:
ERC
Palabras clave:
Acidosis metabólica
Palabras clave:
Mortalidad

In the chronic kidney disease population metabolic acidosis is prevalent presenting already in the early stages of renal dysfunction. The pathogenesis associates the lack of bicarbonate production with the accumulation of organic/inorganic acids and the development of tubulointerstitial damage through ammonium retention and complement deposition. The empiric use of oral sodium bicarbonate represents an interesting therapeutic option that has been documented in a few clinical trials in human subjects. The availability of oral sodium, in its diverse forms, represents an inexpensive and simple way of treating an entity that could hasten the progression of kidney disease, as well as protein catabolism, bone disease and mortality.

Keywords:
Ammonium
Keywords:
Sodium bicarbonate
Keywords:
CKD
Keywords:
Metabolic acidosis
Keywords:
Mortality
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