The experts studied 1,044 individuals with Chronic Kidney Disease (CKD) in the African American Study of Kidney Diseases and Hypertension. It was found that low urine ammonium excretion predicted kidney failure or death in such patients irrespective of serum bicarbonate concentration. Patients with the the lowest levels had a 46 per cent higher risk of dying or needing dialysis when compared to compared to the participants with the highest levels of daily ammonium excretion. Patients with intermediate levels had a 14 per cent higher risk.
"These results suggest that low urine ammonium excretion identifies individuals at high risk of CKD progression or death irrespective of the serum bicarbonate concentration," said Kalani Raphael, University of Utah.
For patients suffering from liver ailments, it becomes important to monitor the body's pH level and keep it in balance. Doctors commonly assess whether a patient's body fluids contain too much acid, a condition called acidosis, by measuring bicarbonate levels in the blood.
This can indicate whether the body is having trouble maintaining its acid-base balance, but it may reveal only part of the picture because the kidneys are important for eliminating acid in the urine. Kalani Raphael from University of Utah in the US and colleagues looked to see if urine levels of ammonium may be a better indicator of acid accumulation in the body.
"Overall, acid levels in the urine provide important information about kidney health above and beyond acid measurements obtained from the blood," Raphael said. The study also suggests that CKD patients with low urine ammonium excretion might benefit from alkali before overt acidosis develops. The findings appear in the Journal of the American Society of Nephrology (JASN).