Renal Function During Metabolic Acidosis: A Review.pdf

This review article discusses renal function changes during metabolic acidosis, a condition marked by low blood pH and increased acid concentration. Metabolic acidosis influences kidney structure and function to restore acid-base homeostasis. Key aspects covered include:

- Renal Blood Flow and Filtration Rate: Studies show mixed results regarding changes in glomerular filtration rate (GFR) during acidosis, with some reporting decreases while others find no significant changes in both humans and animals. Renal blood flow tends to decrease due to systemic arterial pressure reduction.

- Tubular Reabsorption and Excretion: Chronic metabolic acidosis leads to altered reabsorption and excretion of substances:
- Na+ excretion increases proximally but decreases distally initially, linked to reduced Sgk-1 expression.
- K+ excretion rises in rats with chronic acidosis.
- Urinary calcium excretion increases during acidosis in humans.
- Magnesium excretion shows variable responses, with some studies reporting no changes and others noting increased excretion.

- Water Homeostasis: Acidosis influences water homeostasis, leading to progressive increase in sodium reabsorption, possibly due to enhanced NHE3 protein abundance.

- Hypertrophy: Induction of kidney hypertrophy is observed during chronic metabolic acidosis, likely as a compensatory mechanism.

- Proteomics and Gene Expression Analysis: These techniques are valuable tools for understanding changes in the kidneys during acidosis by providing broader insights into protein expression and gene regulation.

The article highlights the complex interplay between metabolic acidosis and kidney function, emphasizing the need for further research to fully elucidate these relationships.