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Metabolic Acidosis and Cardiovascular Disease

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Abstract

Metabolic acidosis can be acute (lasting minutes to a few days) or chronic (lasting weeks to years) in nature. Depression of cardiac function is a common complication of acute metabolic acidosis developing when blood pH is <7.1–7.2. The response to catecholamines is also muted. The mechanisms underlying these effects are complex involving activation of several channels or transporters. Both a reduction in interstitial and intracellular pH appear to play a role. Administration of base in the form of bicarbonate does not improve cardiac function despite improvement in extracellular pH. This might be related to excess generation of carbon dioxide during the buffering process and a reduction in ionized calcium. The link between chronic metabolic acidosis and cardiovascular disease is less clear. No acute effects have been noted. Some studies suggest acidosis contributes to development of hypertension. A role in genesis of ischemic cardiovascular disease is also postulated. The chapter reviews available information on the impact of acute and chronic metabolic acidosis on cardiovascular function, the possible underlying mechanisms, and the impact of base therapy.

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Author information

Authors and Affiliations

  1. Division of Nephrology, VHAGLA Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA

    Jeffrey A. Kraut M.D.

  2. Medicine and Research Services, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA

    Glenn T. Nagami M.D.

  3. Department of Medicine, David Geffen School of Medicine at UCLA, 11301 Wilshire Boulevard, Los Angeles, CA, 90073, USA

    Glenn T. Nagami M.D.

Authors
  1. Jeffrey A. Kraut M.D.
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  2. Glenn T. Nagami M.D.
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Corresponding authors

Correspondence to Jeffrey A. Kraut M.D. or Glenn T. Nagami M.D. .

Editor information

Editors and Affiliations

  1. Baylor Scott & WhiteHealth Dept Int Med., Texas A&M Health Sci. Cent. Collg of Med, Temple, Texas, USA

    Donald E. Wesson

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Kraut, J.A., Nagami, G.T. (2016). Metabolic Acidosis and Cardiovascular Disease. In: E. Wesson, D. (eds) Metabolic Acidosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3463-8_9

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  • DOI: https://doi.org/10.1007/978-1-4939-3463-8_9

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  • Publisher Name: Springer, New York, NY

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