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Metabolic acidosis may lead to impaired physical function4,6,20,34,35,47

Lower serum bicarbonate levels are associated with reduced lower extremity physical function48

  • Data from the NHANES III study showed that serum bicarbonate below 23 mEq/L was associated with low gait speed and quadricep strength after multivariable adjustment48
  • In addition to limiting one’s activities of daily living, worsening lower extremity function has been shown to be strongly predictive of subsequent risk of mortality among patients with CKD49,50

Correcting metabolic acidosis in CKD improves muscle mass and physical function9,10,26,27,51,52

Managing metabolic acidosis may limit loss of bone mineral density34,36,53-56

Serum bicarbonate levels were correlated with the predicted risk of adverse bone and muscle outcomes57

After 2 years, the incidence of fractures and falls and failure to thrive* were significantly higher in patients with metabolic acidosis than patients with normal serum bicarbonate levels (22–29 mEq/L)

*Failure to thrive included muscle and functional outcome.

INCIDENCE OF adverse bone and muscle/functional outcomes at 2 years57

Adverse bone and muscle/functional outcomes at 2 years comparing metabolic acidosis to normal serum bicarbonate.
Increasing serum bicarbonate results in decreased risk of failure to thrive and decreased risk of bone fracture/risk of fall.

Download the Reaven et al Poster #SA-PO836, ASN, 2019 for more information about these data

Correction of metabolic acidosis in CKD patients has beneficial effects on nutritional parameters9,26,51,58-60

Hear from a Patient

Sharon, patient with CKD:

Opinions reflected in the above patient video are those of the patient. CKD is complex and patient symptoms may vary.

Read More

Reaven et al Poster #SA-PO836, ASN, 2019:
Metabolic acidosis is associated with failure to thrive and fractures/falls in patients with chronic kidney disease
download poster
Abramowitz MK (2014):
Acid-base balance and physical function