renal acidosis

Patient care

Renal acidosis due to one of the renal tubular acidoses responds to treatment either with sodium bicarbonate or with citrated salts (e.g., potassium citrate). The acidosis of chronic renal failure may require therapy with sodium bicarbonate or may be treated by dialysis with a bicarbonate-rich dialysate. Diets are adjusted for patients with renal failure to limit the metabolic production of acids (these usually rely on limitations of daily dietary protein). Foods rich in potassium and phosphate are restricted. Patients with renal failure should be monitored for signs and symptoms of renal acidosis, including loss of appetite, changes in levels of consciousness, or alterations in respiratory rate or effort. Laboratory monitoring may include frequent assessments of arterial blood gas values, serum electrolytes, carbon dioxide levels, and blood urea nitrogen and creatinine. Prescribed intravenous fluids are given to maintain hydration.