Chronic kidney disease (CKD) is characterized by progressive reduction in kidney function and treatments aiming at stabilizing or slowing its progression may avoid or delay the necessity of kidney replacement therapy and the increased mortality associated with reduced kidney function. Metabolic acidosis, and less severe stages of the acid stress continuum, are common consequences of CKD and some interventional studies support that its correction slows the progression to end-stage kidney disease. This correction can be achieved with mineral alkali in the form of bicarbonate or citrate salts, ingestion of diets with fewer acid-producing food components or more base-producing food components, or a pharmacological approach. In this mini-review article, we summarize the potential mechanisms involved in the beneficial effects of alkali therapy. We also discuss the perspectives in the field and challenges that must be overcome to advance our understanding of such mechanisms.
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Macrophages are innate immune cells responsible for a variety of tissue-specific homeostatic functions and responding to infiltrating pathogens. A lot of what we know about macrophages comes from studies on unphysiological 2D plastic dishes, however new insights into macrophage biology are emerging thanks to 3D cell culture technology (see the review in this issue by Cutter et al., pages 387–401). Depicted here is a macrophage suspended within a neon 3D dimension. Image provided by Katrina Binger.
The mechanisms of alkali therapy in targeting renal diseases
Pedro Henrique Imenez Silva, Donald E. Wesson, Carsten A. Wagner; The mechanisms of alkali therapy in targeting renal diseases. Biochem Soc Trans 27 February 2023; 51 (1): 223–232. doi: https://doi.org/10.1042/BST20220690
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