Uncontrolled CKD commonly leads to what acid-base disturbance?

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Prepare for the HESI Chronic Kidney Disease Case Study Exam with multiple-choice questions and detailed explanations. Boost your confidence for success!

Multiple Choice

Uncontrolled CKD commonly leads to what acid-base disturbance?

Explanation:
In uncontrolled CKD, the kidneys can’t excrete acid effectively or regenerate bicarbonate, so nonvolatile acids accumulate and bicarbonate falls. To maintain electroneutrality, chloride rises as bicarbonate disappears, producing a metabolic acidosis with a normal (hyperchloremic) anion gap. This pattern contrasts with high anion gap metabolic acidosis, where unmeasured anions accumulate (as in lactic or ketoacidosis). So the typical CKD acid-base disturbance is metabolic acidosis with a normal anion gap due to hyperchloremia.

In uncontrolled CKD, the kidneys can’t excrete acid effectively or regenerate bicarbonate, so nonvolatile acids accumulate and bicarbonate falls. To maintain electroneutrality, chloride rises as bicarbonate disappears, producing a metabolic acidosis with a normal (hyperchloremic) anion gap. This pattern contrasts with high anion gap metabolic acidosis, where unmeasured anions accumulate (as in lactic or ketoacidosis). So the typical CKD acid-base disturbance is metabolic acidosis with a normal anion gap due to hyperchloremia.

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