It is well-known that impaired renal ammonium excretion is one of the predisposing factors for the pathogenesis of acidosis. In this regard, a recently published study evaluated if earlier detection of low ammonium excretion can be better and an earlier indicator than serum bicarbonate in CKD patients without acidosis. Study Objective In nondialysis-requiring CKD, the metabolic acidosis is defined as serum total carbon dioxide, 22mEg/L, which is approximately 15%. Some studies indicate low total CO 2 as a risk factor for GFP decline and mortality.
However, differences in the population characteristics and study design give rise to discrepancies. Urine ammonium is critical for maintaining normal total CO 2 and hence reduced urine ammonium excretion develops metabolic acidosis in CKD, which can be considered as an alternative or an earlier indicator of risk than total CO 2 . Hence the…
