Bailey J L, Mitch W E
Renal Division, Emory University School of Medicine, Atlanta, GA 30322, USA.
Semin Nephrol. 1996 May;16(3):160-6.
Patients with chronic renal failure suffer from a muscle wasting syndrome that is characterized by loss of lean body mass and negative nitrogen balance. Evidence is provided indicating that metabolic acidosis plays a major role in initiating these adverse effects. In particular, we discuss findings suggesting that metabolic acidosis mitigates its effects by activating the cytosolic ubiquitin proteasome proteolytic pathway. Additional evidence that metabolic acidosis alters vitamin D and parathyroid hormone levels is provided. Therapy that includes correction of the metabolic acidosis with alkali in the form of sodium bicarbonate supplements has significant therapeutic implications for uremic patients with even mild degrees of metabolic acidosis.
慢性肾衰竭患者会出现肌肉萎缩综合征，其特征为瘦体重减少和负氮平衡。有证据表明，代谢性酸中毒在引发这些不良反应中起主要作用。特别是，我们讨论了一些研究结果，这些结果表明代谢性酸中毒通过激活胞质泛素蛋白酶体蛋白水解途径来减轻其影响。还提供了代谢性酸中毒会改变维生素D和甲状旁腺激素水平的额外证据。对于即使患有轻度代谢性酸中毒的尿毒症患者，用碳酸氢钠补充剂形式的碱来纠正代谢性酸中毒的治疗具有重要的治疗意义。
