Disorders of the renal function and/or pathological changes in the renal structure are triggers of a renal failure. The capacity of the kidneys to excrete urophanic metabolic substances decreases. The more advanced the disease symptoms are, the higher is the incapability to keep the acid-base balance in the blood. So a renal failure affects primarily the acidity regulation. That’s the starting point for the development of a metabolic acidosis in connection with a renal impairment. The bicarbonate buffer system will change towards a deficit.

The incidence of the metabolic acidosis increases proportionally according to the degree of the renal failure and with the decrease of the renal function respectively.

This kind of acidosis connected with a chronic kidney disease (CKD, stage 2 to 4) must be treated as early as possible and for a long time. This will contribute to the recovery of the renal function and restore the homeostasis. The latter must be sought in view of the proven long-term complications of metabolic acidosis: e.g. impairment of the muscle metabolism, decrease of the bone mineral density, decrease of the insulin effectiveness, and reduction of the cardiac function.