| [ Summary ] |
Hydrogen ions (H+) are essential for cellular functions and the concentration of H+ (or pH) must be strictly regulated within a very narrow range. In chronic renal failure, diminished excretion of H+ and an accumulation of non-volatile acids are both responsible for metabolic acidosis and acid-base disorders. Metabolic acidosis may cause the progression of renal failure associated with an adaptive increase in ammonia production, renal osteodystrophy due to bone buffering, skeletal muscle breakdown, and hyperkalemia. Sodium bicarbonate therapy for acidosis may be beneficial for patients with chronic renal failure, but should be given while considering plasma bicarbonate concentrations, pH, anion gaps, hypertension and edema, hypocalcemia, and hyperkalemia. |