Next up at #AspenKidney is Jessica Kendrick fellowship PD to talk about CKD and Acid-Base Disorders 
Metabolic acidosis, defined as HCO3 < 22, is found in 20% of stage 4 CKD. #AspenKidney
Ammonia is responsible for most of the renal adaption to metabolic acidosis. Requires proximal tubule function. Becomes problematic as GFR falls below 45. #AspenKidney
Patient develop positive acid balance. 10-20 mEq per day especially with GFR less than 45.
Urinary ammonia predicts future metabolic acidosis #AspenKidney
Urinary ammonia predicts future metabolic acidosis #AspenKidney
No association of metabolic acidosis with fractures despite tight association with BMD and metabolic acidosis. #AspenKidney
Higher risk of CHF in MESA and CRIC data for HCO3 over 26. Concerning. #AspenKidney
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