Clinical Consequences of Metabolic Acidosis—Muscle

Research output: Contribution to journalReview articlepeer-review


Metabolic acidosis is common in people with chronic kidney disease and can contribute to functional decline, morbidity, and mortality. One avenue through which metabolic acidosis can result in these adverse clinical outcomes is by negatively impacting skeletal muscle; this can occur through several pathways. First, metabolic acidosis promotes protein degradation and impairs protein synthesis, which lead to muscle breakdown. Second, metabolic acidosis hinders mitochondrial function, which decreases oxidative phosphorylation and reduces energy production. Third, metabolic acidosis directly limits muscle contraction. The purpose of this review is to examine the specific mechanisms of each pathway through which metabolic acidosis affects muscle, the impact of metabolic acidosis on physical function, and the effect of treating metabolic acidosis on functional outcomes.

Original languageEnglish (US)
Pages (from-to)395-405
Number of pages11
JournalAdvances in Chronic Kidney Disease
Issue number4
StatePublished - Jul 2022


  • Acidosis
  • Bicarbonate
  • Chronic kidney disease
  • Muscle
  • Physical function

ASJC Scopus subject areas

  • Nephrology


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