Ammonium excretion in chronic metabolic acidosis: benefits and risks

Am J Kidney Dis. 1989 Oct;14(4):267-71. doi: 10.1016/s0272-6386(89)80200-8.


The expected renal response to a chronic acid load is an enhanced rate of ammonium production and excretion. Notwithstanding, high rates of ammonium production and/or excretion on a chronic basis may have detrimental consequences to patients. Examples discussed include the loss of extra lean body mass during chronic fasting, an accelerated rate of progression of renal insufficiency and possibly destruction of the medullary area of the kidney owing to local alkalinization.

Publication types

  • Review

MeSH terms

  • Acidosis / metabolism*
  • Ammonia / metabolism*
  • Animals
  • Chronic Disease
  • Fasting / metabolism
  • Humans
  • Ketosis / metabolism
  • Kidney / metabolism*
  • Kidney Failure, Chronic / metabolism


  • Ammonia