[Renal metabolic acidosis: physiopathology, diagnosis and treatment].

Metabolic acidosis is not uncommon in clinical medicine. The kidney plays a pivotal role to maintain acid-base homeostasis. Understanding renal acid-base metabolism is essential to make an effective approach to the diagnosis and management of metabolic acidosis. Clinical approach includes the serum anion gap which allows to classify metabolic acidosis as increased anion gap or non-anion gap acidosis. Renal tubular acidosis refers to a group of functional disorders which differ depending on the localisation of the tubular defect. The management of metabolic acidosis is discussed according to the causes. The indications to use sodium bicarbonate are discussed as well as its potential adverse effects in some conditions.