[Screening and management of metabolic acidosis in patients with chronic kidney disease].

Metabolic acidosis is a frequent and early biological abnormality of chronic kidney disease (CKD). Chronic metabolic acidosis affects the global homeostasis of the human body, including the metabolism of bone and muscles. Numerous studies have proved a causal relationship between metabolic acidosis and accelerated CKD progression. Hence, the measure of serum bicarbonate level should be part of the systematic follow-up of CKD patients of whom glomerular filtration rate decreases below 50 ml/min/1.73m². Both screening and treatment of metabolic acidosis are easy and cheap. Correcting metabolic acidosis, namely by the daily administration of sodium bicarbonate, helps slow down kidney decline.