The Continuum of Acid Stress.

Abstract

Acid-related injury from chronic metabolic acidosis is recognized through growing evidence of its deleterious effects, including kidney and other organ injury. Progressive acid accumulation precedes the signature manifestation of chronic metabolic acidosis, decreased plasma bicarbonate concentration. Acid accumulation that is not enough to manifest as metabolic acidosis, known as eubicarbonatemic acidosis, also appears to cause kidney injury, with exacerbated progression of CKD. Chronic engagement of mechanisms to mitigate the acid challenge from Western-type diets also appears to cause kidney injury. Rather than considering chronic metabolic acidosis as the only acid-related condition requiring intervention to reduce kidney injury, this review supports consideration of acid-related injury as a continuum. This "acid stress" continuum has chronic metabolic acidosis at its most extreme end, and high-acid-producing diets at its less extreme, yet detrimental, end.

• Authors: Donald E Wesson
• Journal: Clinical journal of the American Society of Nephrology : CJASN (Clin J Am Soc Nephrol) Vol. 16 Issue 8 Pg. 1292-1299 (08 2021) ISSN: 1555-905X [Electronic] United States
• PMID: 33741720 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)
• Copyright: Copyright © 2021 by the American Society of Nephrology.

Chemical References

• Acids
• Bicarbonates

Topics

• Acid-Base Equilibrium
• Acidosis (blood, complications, physiopathology)
• Acids (metabolism)
• Bicarbonates (blood)
• Chronic Disease
• Diet
• Glomerular Filtration Rate
• Humans
• Kidney Diseases (etiology)
• Stress, Physiological