In all forms of chronic acidosis, regardless of cause, elimination of fixed base is increased. In some instances, increase in the elimination of fixed base is the primary cause of acidosis. Prolonged excessive loss of fixed base will deplete calcium reserves. According to the authors' concept, the development of rickets concomitant with chronic acidosis is due to the associated deficiency of base, regardless of other factors involved.
Chronic renal insufficiency is the commonest antecedent of rickets associated with chronic acidosis. The term "renal rickets" properly refers to the syndrome of impaired growth, static deformities of bone and rickets-like epiphysial changes seen in children with chronic renal insufficiency. In these children the underlying disturbance is dependent on structural changes within the kidney. Rickets, when present, is to be regarded as a sequel; its importance is overshadowed by the more serious limitation of renal function. Because of the irreversibility of the structural
BOYD JD, STEARNS G. CONCOMITANCE OF CHRONIC ACIDOSIS WITH LATE RICKETS. Am J Dis Child. 1942;64(4):594-607. doi:10.1001/archpedi.1942.02010100020002