This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Chronic Kidney Disease and Uremia, Subject name: Medicine
CRF is associated with? 
Select and explain. 
A. Respiratory acidosis, B. Respiratory alkalosis, C. Metabolic acidosis, D. Metabolic alkalosis
C: Metabolic acidosis
Answer: C: Metabolic acidosis 
Explanation: ANSWER: (C) Metabolic acidosisREF: Harrison 17th ed chapter 274, Essentials of Pathophysiology: Concepts of Altered Health States by Carol Mattson Forth page 200Chronic kidney disease is the most common cause of chronic metabolic acidosis. The kidneys normally conserve HCO3-- and secrete H+ ions into the urine as a means of regulating acid-base balance. In chronic kidney disease, there is loss of both glomerular and tubular function with retention of nitrogenous waste and metabolic acids. In condition called renal tubular acidosis, glomerular function is normal, but tubular secretion of H+ or reabsorption of HC03~ is abnormal.