etabolic acidosis is an important acid-base disturbance
in humans. It is characterized by a primary decrease in
body bicarbonate stores and is known to induce multiple
endocrine and metabolic alterations. Metabolic acidosis
induces nitrogen vesting and in humans, depresses
protein metabolism. Meabolic acidosis induces a negative
calcium balance (resorption from bone) with
hypercalciurea and a propensity to develop kidney
stones. Metabolic acidosis also results in
hypophosphataemia due to renal phosphate wasting.
Negative calcium balance and phosphate depletion
combine to induce a metabolic bone disease that exhibits
features of both osteoporosis and osteomalacia. In
humans at least, 1,25-(OH)2 vitamin D levels increase,
probably through phophate depletion-induced stimulation
of 1-alpha hydroxylase. The production rate of 1,25-
(OH)2 vitamin D is thus stimulated, and parathyroid
hormone decreases secondarily. There is experimental
evidence to support the notion that even mild degrees of
acidosis, such as that occurring by digestion of high
animal protein diet, induces some of these metabolic and
endocrine effects. The possible role of diet-induced acid
loads in nephrolithiasis, age-related loss of lean body
mass and osteoporosis is discussed.
M Wiederkehr, R Krapf, Swiss Med Wkly 2001;131:127-132
Copyright © 2003 Anamol Laboratories Ltd.
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