Role of Acid-Base Homeostasis in Diabetic Kidney Disease.

Journal Article (Journal Article;Review)

PURPOSE OF REVIEW: Acid-base homeostasis is impaired in chronic kidney disease (CKD) and may contribute to disease progression. Diabetes, a major cause of CKD worldwide, may exacerbate acidosis further due to differences in acid production and excretion. Here, we review the role of abnormal acid-base homeostasis in the pathogenesis and progression of diabetes and diabetic kidney disease. RECENT FINDINGS: Acidosis and dietary acid loading may contribute to the development and worsening of insulin resistance and hypertension, thereby promoting diabetes and diabetic CKD. However, although metabolic acidosis associates with progression of CKD generally, the results in diabetic CKD are mixed. Data suggests that metabolic acid production in diabetes may be higher than would be predicted based on dietary intake alone, and new observational data suggests that this higher diet-independent acid production could potentially be protective. The role of acid-base homeostasis in diabetic CKD progression is complex and must consider differences in endogenous acid production and excretion in diabetes. Ongoing observational and interventional studies in this field should consider the unique physiology of diabetes.

Full Text

Duke Authors

Cited Authors

  • Khairallah, P; Scialla, JJ

Published Date

  • April 2017

Published In

Volume / Issue

  • 17 / 4

Start / End Page

  • 28 -

PubMed ID

  • 28343312

Electronic International Standard Serial Number (EISSN)

  • 1539-0829

Digital Object Identifier (DOI)

  • 10.1007/s11892-017-0855-6


  • eng

Conference Location

  • United States