What is a common metabolic complication associated with chronic kidney disease?

Chronic kidney disease (CKD) often leads to a range of metabolic complications, one of the most significant of which is metabolic acidosis. In CKD, the kidneys’ ability to excrete hydrogen ions and reabsorb bicarbonate is compromised. As the disease progresses, there is a decrease in the glomerular filtration rate (GFR), contributing to a buildup of acids in the body, specifically organic acids. This results in a lower serum bicarbonate level, leading to a state of acidosis.

Additionally, the inability to excrete ammonium contributes to the accumulation of acid in the body, exacerbating the condition. Metabolic acidosis in CKD can lead to bone disease, as the body attempts to buffer the excess acid by mobilizing calcium and phosphate from the bone, potentially leading to further complications.

In contrast, hypercalcemia, metabolic alkalosis, and hypokalemia are generally less common in the context of CKD. Hypercalcemia can occur in certain conditions but is not typical in CKD; metabolic alkalosis tends to occur due to other conditions, often compensatory mechanisms, while hypokalemia is more frequently associated with conditions that lead to excess potassium loss.