What is the primary effect of renal replacement therapy on acid-base status?

• A. It worsens acidosis initially
• B. It helps correct metabolic acidosis and restore acid-base balance
• C. It has no effect on acid-base
• D. It causes metabolic alkalosis

Answer: (B)

Renal replacement therapy restores acid-base balance by correcting metabolic acidosis in kidney failure. When the kidneys can’t excrete hydrogen ions or regenerate bicarbonate, metabolic acidosis develops from the buildup of nonvolatile acids. Dialysis removes these acids and hydrogen ions from the blood and provides bicarbonate through the dialysate, which buffers and neutralizes excess acid. This process shifts the patient’s acid-base status toward normal and helps reestablish balance between acids and bases. It’s not about making acidosis worse or leaving it unchanged, and while overcorrection to metabolic alkalosis is possible in unusual situations, the primary and expected effect is the correction of metabolic acidosis.