Which acid-base imbalance is associated with altered urinary elimination due to chronic kidney disease (CKD)?

Metabolic acidosis is the correct answer because chronic kidney disease (CKD) impairs the kidneys' ability to excrete hydrogen ions and reabsorb bicarbonate, leading to an accumulation of acids in the body. The kidneys are crucial for maintaining acid-base balance, and when their function declines, as seen in CKD, the body's ability to eliminate acids is compromised. This results in an increase in serum hydrogen ion concentration, which is the hallmark of metabolic acidosis.

In CKD, altered urinary elimination manifests as the kidneys struggle to deliver an adequate amount of bicarbonate into the bloodstream and efficiently remove excess acids. Consequently, patients often experience a decrease in blood pH, leading to a state of acidosis.

Understanding how metabolic acidosis develops in the context of CKD clarifies this significant physiological change, affecting multiple systems in the body. Other acid-base imbalances such as respiratory acidosis and alkalosis primarily relate to issues with carbon dioxide levels due to respiratory function rather than renal impairment, which makes them less relevant in this context. Metabolic alkalosis does not align with the typical acid-base disturbances seen in CKD, as it generally involves an excess of bicarbonate or a significant loss of hydrogen ions, scenarios that are less common in