Acidosis

The Most Serious Consequence of Renal Failure is Acidosis

The most serious consequence of renal failure is acidosis. Acidosis occurs when the excretory process is unable to keep up with the daily generation of acid, resulting in a drop in glomerular filtration rate (GFR) to less than 30ml per minute. The primary cause of this failure is a decrease in renal ammonia generation as a result of a decrease in the number of functional nephrons. The production and consumption of these acids and bases are determined by excretion in healthy persons (Kovesdy 2012). The kidney is crucial in maintaining the acid-base balance by excreting acids in equivalent proportions to extrarenal production. The kidney manages the situation through absorption of filtered bicarbonate, and consequently by regeneration of base through excreting ammonium and titratable acid.

Metabolic Acidosis in Chronic Kidney Disease

In the case of chronic kidney disease, the metabolic acidosis results in bicarbonate levels remaining above 15mE/L limit due to lack of concomitant comorbidities. The existence of acidosis is heightened by the advancement of chronic kidney disease which leads to renal failure (Kovesdy 2012). Patients suffering from acidosis display some physical and clinical indicators. They include reduced respiratory reserve, osteopenia, as well as reduction of red blood cells activity and myocardial cells which can result in congestive heart failure. The other clinical effects associated with the condition include chronic inflammation and abnormal glucose homeostasis. Acidosis is also affiliated with a significant increment in the mortality rate among patients with renal failures and those that lack chronic kidney disease dialysis. In summary, the acidosis occurs through activation of regulatory mechanisms which helps in the rectification of disfigured balance of acid-base consequently inducing renal failure.

References

Kovesdy, C.P. (2012). Metabolic acidosis and kidney disease: Does bicarbonate therapy slow the progression of CKD? Nephrology Dialysis Transportation, 27(8), 3056-3062: doi.org/10.1093.