Clinical Report: Metabolic Acidosis Care Limited in Chronic Kidney Disease
Overview
Revise to explicitly connect the statistics on diagnosis and treatment rates to the study's findings.
Background
Metabolic acidosis is a common complication in patients with chronic kidney disease, associated with worsening kidney function and adverse outcomes. Despite guidelines recommending routine monitoring and treatment, the actual practice in Japan shows low rates of serum bicarbonate measurement and treatment. Understanding and addressing these gaps is crucial for improving patient care in CKD.
Data Highlights
| CKD Stage | Prevalence of Metabolic Acidosis | Diagnosis Rate | Treatment Rate |
|---|---|---|---|
| G3a | 32% | 5% | 4% |
| G3b | 46% | 7% | 5% |
| G4 | 66% | 14% | 13% |
Key Findings
- 44% of patients with at least one serum bicarbonate measurement had metabolic acidosis.
- Serum bicarbonate was measured in only 8-9% of patients annually.
- Diagnosis and treatment rates for metabolic acidosis increased with CKD severity.
- Patients tested for serum bicarbonate were older and had more advanced kidney disease.
- Only 9% of patients with metabolic acidosis received a formal diagnosis.
- 8% of patients with metabolic acidosis were treated during the study period.
Clinical Implications
Healthcare providers should prioritize the assessment and management of metabolic acidosis in patients with chronic kidney disease, particularly as its prevalence increases with disease severity. Routine serum bicarbonate measurements and timely interventions are essential to improve patient outcomes.
Conclusion
The study underscores the need for enhanced clinical practices regarding the assessment and treatment of metabolic acidosis in chronic kidney disease patients in Japan. Addressing these deficiencies could lead to better management and improved patient health outcomes.
References
- KDIGO, KDIGO, 2024 -- 2024 CKD Guideline
- Intensive Care Medicine, 2025 -- Bicarbonate level in replacement fluid during CVVH: less is more!
- Intensive Care Medicine, 2026 -- Sodium bicarbonate application for the treatment of acute metabolic acidosis: what we know and what we still don’t know
- Intensive Care Medicine, 2025 -- Evaluating the Impact of Sodium Bicarbonate Treatment on Metabolic Acidosis in ICU Settings: Insights from a Target Trial Emulation
- Effects of correcting metabolic acidosis in chronic kidney disease patients: An umbrella review, 2026
- Critical Care (Springer) — Incidence, severity, and predictors of citrate accumulation during continuous kidney replacement therapy in the critically ill
- https://kdigo.org/wp-content/uploads/2024/03/KDIGO-2024-CKD-Guideline.pdf
- Effects of correcting metabolic acidosis in chronic kidney disease patients: An umbrella review - Percy Herrera-Añazco, Miguel A. Huayta-Cortez, Juan R. Ulloque-Badaracco, Christian N. Rojas, Nella Altamirano-Cabezas, Vicente A. Benites-Zapata, 2026
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