How does metabolic acidosis impact patients with chronic kidney disease (CKD)?

Metabolic acidosis is a common complication in patients with chronic kidney disease (CKD) due to the kidneys' impaired ability to excrete hydrogen ions and reabsorb bicarbonate. This acid-base imbalance can significantly affect several physiological processes in the body.

Muscle wasting is a concern because the body begins to break down muscle tissue to counteract the acidity, resulting in an increased catabolism of proteins. Additionally, prolonged metabolic acidosis can lead to an increase in the breakdown of bones as the body releases calcium and phosphate to buffer the excess acid, which can decrease bone mineral density over time. This dual impact of muscle loss and reduced bone strength is critical in CKD patients, contributing to frailty and increased risk of fractures.

The other options provided do not accurately reflect the consequences of metabolic acidosis in CKD. While some might speculate on indirect effects like elevated blood sugar levels or kidney stone formation, the more immediate and clinically relevant consequences center around issues of muscle and bone health, making the selected answer the most appropriate in this context.