This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
In renal failure, metabolic acidosis is due to 
Select and explain. 
A. Increased fr production, B. Loss of HCO,, C. Decreased ammonia synthesis, D. Use of diuretics
C: Decreased ammonia synthesis
Answer: C: Decreased ammonia synthesis 
Explanation: Ans. is 'c' i.e., Decreased ammonia synthesis The predominant reason for metabolic acidosis in C.R.E is decreased ammonia production. Metabolic acidosis is a common disturbance in advanced chronic kidney disease The majority of patients can still acidly the urine but they produce less ammonia and, therefore, cannot excrete the normal quantity of protons in combination with this urinary buffer.