Volume 77, Issue 7, Pages (April 2010)

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Volume 77, Issue 7, Pages 567-569 (April 2010) A basic approach to CKD Eric E. Simon, L. Lee Hamm Kidney International Volume 77, Issue 7, Pages 567-569 (April 2010) DOI: 10.1038/ki.2009.516 Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 1 Mechanisms linking acidosis and CKD. CKD leads to metabolic acidosis, which may promote interstitial fibrosis due to adaptations in ammonia handling. Additionally, the acidic milieu may stimulate endothelin (ET) production, which may promote interstitial fibrosis. However, endothelin may have a salutatory effect of promoting acid secretion, which would ameliorate the acidosis (X). Bicarbonate therapy would directly ameliorate the acidosis (X). ETA, endothelin A; ETB, endothelin B. Kidney International 2010 77, 567-569DOI: (10.1038/ki.2009.516) Copyright © 2010 International Society of Nephrology Terms and Conditions