患者，男性，36岁，慢性肾炎多年。近来出现恶心，呕吐，呼吸深而快。血尿素氮20mmol/L(55mg/dl),肌酐450μmol/L(5mg/dl),血pH7.25,血HC03-20mmol/L。该肾功能处于

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