Evidence map›Paper›PMID 19608703›Full record

Trial reportJournal of the American Society of Nephrology : JASN2009

Bicarbonate supplementation slows progression of CKD and improves nutritional status.

Ione de Brito-Ashurst, Mira Varagunam, Martin J Raftery, Muhammad M Yaqoob

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 330 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
330citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01225796 early_phase1completednot on this mapstarted 2010, after this paper: background citation

Randomized Trial of Sodium Bicarbonate in Renal Transplant Recipients With Low-normal Serum Bicarbonate Levels

TypeinterventionalSponsorUniversity of UtahRan2010 to 2012Enrolled29ConditionsKidney TransplantationArmsSodium bicarbonate
NCT02896309 nacompletednot on this mapstarted 2016, after this paper: background citation

The Effect of Correction of Metabolic Acidosis in CKD on Intrarenal RAS Activity

TypeinterventionalSponsorErasmus Medical CenterRan2016 to 2018Enrolled45ConditionsChronic Kidney DiseaseArmsSodium bicarbonate, Sodium chloride
3 · Its place in the literature

Who cites it

330 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Effects of Treatment of Metabolic Acidosis in CKD: A Systematic Review and Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2019
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  12. Effects of veverimer on serum bicarbonate and physical function in diabetic patients with chronic kidney disease and metabolic acidosis: subgroup analysis from a randomized, controlled trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022
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  17. Effects of Sodium Bicarbonate in CKD Stages 3 and 4: A Randomized, Placebo-Controlled, Multicenter Clinical Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2020
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270 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Ione de Brito-AshurstDepartment of Renal Medicine and Transplantation, William Harvey Research Institute and Barts and the London NHS Trust, London, UK.
Mira Varagunam
Martin J Raftery
Muhammad M Yaqoob

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bicarbonate supplementation preserves renal function in experimental chronic kidney disease (CKD), but whether the same benefit occurs in humans is unknown. Here, we randomly assigned 134 adult patients with CKD (creatinine clearance [CrCl] 15 to 30 ml/min per 1.73 m(2)) and serum bicarbonate 16 to 20 mmol/L to either supplementation with oral sodium bicarbonate or standard care for 2 yr. The primary end points were rate of CrCl decline, the proportion of patients with rapid decline of CrCl (>3 ml/min per 1.73 m(2)/yr), and ESRD (CrCl <10 ml/min). Secondary end points were dietary protein intake, normalized protein nitrogen appearance, serum albumin, and mid-arm muscle circumference. Compared with the control group, decline in CrCl was slower with bicarbonate supplementation (5.93 versus 1.88 ml/min 1.73 m(2); P < 0.0001). Patients supplemented with bicarbonate were significantly less likely to experience rapid progression (9 versus 45%; relative risk 0.15; 95% confidence interval 0.06 to 0.40; P < 0.0001). Similarly, fewer patients supplemented with bicarbonate developed ESRD (6.5 versus 33%; relative risk 0.13; 95% confidence interval 0.04 to 0.40; P < 0.001). Nutritional parameters improved significantly with bicarbonate supplementation, which was well tolerated. This study demonstrates that bicarbonate supplementation slows the rate of progression of renal failure to ESRD and improves nutritional status among patients with CKD.

Indexed as

Nutritional StatusAcidosisAdministration, OralBlood ProteinsCreatinineDietary ProteinsDisease ProgressionFemaleHumansKaplan-Meier EstimateKidney Failure, ChronicMaleMiddle AgedSerum AlbuminSodium BicarbonateTreatment OutcomeBlood ProteinsCreatinineDietary ProteinsSerum AlbuminSodium Bicarbonate

Identifiers

PMID19608703
PMCPMC2736774

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.