Article name: Urine Ammonium, Metabolic Acidosis and Progression of Chronic Kidney Disease
This article was published in Nephron in 2018. It is a review article that elaborates in the mechanisms of how metabolic acidosis is implicated in the progression of CKD
The article mentions the interesting finding that in African American Patients with CKD, hypertension, and no acidosis, a daily urinary ammonium (uNH4) lower than 20 mEq is predictive of death or progression to ESRD. This may represent that patients with impaired acid excretion and prone to acidosis can progress faster regarding CKD and are at a higher risk of death