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The only available therapeutic modality, involving intravenous infusion of NaHCO<jats:sub>3<\/jats:sub>, engenders undesirable sodium retention, thereby increasing hemodynamic load and seriously exacerbating the primary disease. This deleterious cascade extends to the development of cardiovascular diseases. Herein, an orally administered, gut\u2010restricted inorganic adsorbent that can effectively alleviate chronic metabolic acidosis without causing any electrolytic derangement or superfluous cardiovascular strain is developed. The genesis of ABC\u2010350 entails the engineering of bismuth subcarbonate via annealing, thereby yielding a partially \u03b2\u2010Bi<jats:sub>2<\/jats:sub>O<jats:sub>3<\/jats:sub>\u2010doped (BiO)<jats:sub>2<\/jats:sub>CO<jats:sub>3<\/jats:sub> biphasic crystalline structure framework enriched with atomic vacancies. ABC\u2010350 can selectively remove chloride ions and protons from the gastrointestinal tract, mimicking the physiological response to gastric acid removal and resulting in increased serum bicarbonate. Owing to its gut\u2010restricted nature, ABC\u2010350 exhibits commendable biosafety, averting undue systemic exposure. In two rat models of metabolic acidosis, ABC\u2010350 emerges not only as a potent mitigator of acidosis but also effects discernible amelioration concerning proximal tubular morphology, interstitial fibrosis, and the incendiary cascades incited by metabolic acidosis. ABC\u2010350, as the translationally relevant material, provides a promising strategy for the treatment of metabolic acidosis.<\/jats:p>","DOI":"10.1002\/adma.202305992","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T09:42:29Z","timestamp":1699004549000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Counterion\u2010Free Strategy for Chronic Metabolic Acidosis Based on an Orally Administered Gut\u2010Restricted Inorganic Adsorbent"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-050X","authenticated-orcid":false,"given":"Zhen","family":"Liu","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Xiang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7719-9896","authenticated-orcid":false,"given":"Meng","family":"Tian","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kangfei","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianzhi","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangpeng","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Materials Science and Engineering Tongji University  Shanghai 201384 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Mu","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering ShanghaiTech University  Shanghai 201210 China"},{"name":"University of Chinese Academy of Sciences  Beijing 100049 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingxue","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Pharmacy Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-5992","authenticated-orcid":false,"given":"Shiyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0543-4778","authenticated-orcid":false,"given":"Jie","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shanghai Jiao Tong University  Shanghai 200240 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,12]]},"reference":[{"key":"e_1_2_9_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32064-5"},{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32977-0"},{"key":"e_1_2_9_1_3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30045-3"},{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.88"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.155"},{"key":"e_1_2_9_2_3","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-021-00488-2"},{"key":"e_1_2_9_2_4","first-page":"68","volume":"6","author":"Segar M. 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