ReviewDiagnostics (Basel, Switzerland)2025
Metabolic Acidosis in Patients with Chronic Kidney Disease: Diagnosis, Pathogenesis, and Treatment-A Narrative Review.
Review in Diagnostics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Long-term survival prognosis and risk stratification after radical cystectomy with Mainz Pouch II urinary diversion: a retrospective cohort study and prognostic model construction.Translational andrology and urology · 2026Article
- Article
- The kidney and the balance of sulfur and nitrogen as fundamental components of pH homeostasis.Physiological reports · 2026Review
- Microbiota-derived metabolites and cognitive dysfunction in dialysis patients: mechanisms and targeted therapeutic strategies.Frontiers in microbiology · 2026Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Metabolic acidosis is a common complication of chronic kidney disease (CKD). The kidneys play a crucial role in acid-base balance, maintaining pH within the normal range (isohydria) by following mechanisms: bicarbonate reabsorption, ammogenesis, and titratable acidity. The anion gap describes the amount of unmeasured anions and is classically evaluated as the difference between the major cation (sodium) and the sum of the two major anions (chloride and bicarbonate). Metabolic acidosis can be divided into two types: normal anion gap metabolic acidosis and high anion gap metabolic acidosis. A high anion gap level is considered unfavorable in terms of prognosis as it is associated with increased mortality. Treatment of metabolic acidosis in patients with chronic kidney disease, despite available therapeutic options, is a challenge. Supplementation with bicarbonates does not improve prognosis on the one hand, and on the other hand, it may be harmful. The new KDIGO guidelines for 2024 have been significantly modified compared to 2012 after negative results of studies on bicarbonate supplementation. Bicarbonate supplementation is currently recommended only when levels are less than 18 mmol/L. This review provides an overview of the current knowledge on the pathophysiology, classification, and therapeutic options, including dietary recommendations and new pharmacology agents.
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