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Role of Acid-Base Homeostasis in Diabetic Kidney Disease.
Curr Diab Rep. 2017 04; 17(4):28.CD

Abstract

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.

Authors+Show Affiliations

Department of Medicine, Duke University School of Medicine, Durham, NC, USA.Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. Julia.scialla@duke.edu. Department of Medicine, Durham Veterans Affairs Medical Center, Durham, NC, USA. Julia.scialla@duke.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28343312

Citation

Khairallah, Pascale, and Julia J. Scialla. "Role of Acid-Base Homeostasis in Diabetic Kidney Disease." Current Diabetes Reports, vol. 17, no. 4, 2017, p. 28.
Khairallah P, Scialla JJ. Role of Acid-Base Homeostasis in Diabetic Kidney Disease. Curr Diab Rep. 2017;17(4):28.
Khairallah, P., & Scialla, J. J. (2017). Role of Acid-Base Homeostasis in Diabetic Kidney Disease. Current Diabetes Reports, 17(4), 28. https://doi.org/10.1007/s11892-017-0855-6
Khairallah P, Scialla JJ. Role of Acid-Base Homeostasis in Diabetic Kidney Disease. Curr Diab Rep. 2017;17(4):28. PubMed PMID: 28343312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of Acid-Base Homeostasis in Diabetic Kidney Disease. AU - Khairallah,Pascale, AU - Scialla,Julia J, PY - 2017/3/27/entrez PY - 2017/3/28/pubmed PY - 2017/8/5/medline KW - Acid load KW - Acidosis KW - CKD KW - CKD progression KW - Diabetes KW - Diabetic nephropathy KW - Insulin resistance SP - 28 EP - 28 JF - Current diabetes reports JO - Curr Diab Rep VL - 17 IS - 4 N2 - 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. SN - 1539-0829 UR - https://www.unboundmedicine.com/medline/citation/28343312/Role_of_Acid_Base_Homeostasis_in_Diabetic_Kidney_Disease_ L2 - https://dx.doi.org/10.1007/s11892-017-0855-6 DB - PRIME DP - Unbound Medicine ER -