EFFECT OF CORRECTION OF CHRONIC METABOLIC ACIDOSIS BY ORAL SODIUM BICARBONATE THERAPY ON NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTS

Abstract

Metabolic acidosis is a common health problem among CKD patients, particularly those on dialysis. K/DOQI guidelines suggested treating acidosis when serum bicarbonate levels are below 22, but didn’t impose a specific therapy scheme for metabolic acidosis in CKD subjects. Chronic metabolic acidosis has multiple consequences including decreased albumin synthesis, increased muscle wasting, generation and exacerbation of bone disease, growth retardation in children and many other effects. Protein energy wasting (PEW) is a syndrome of adverse changes in nutrition and body composition, highly prevalent in patients with chronic kidney disease (CKD), especially in those undergoing dialysis, and it is associated with high morbidity and mortality. Metabolic acidosis is an important contributing factor in the pathogenesis of PEW.