Evidence map›Paper›PMID 24953891›Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2014

Low serum bicarbonate and kidney function decline: the Multi-Ethnic Study of Atherosclerosis (MESA).

Todd H Driver, Michael G Shlipak, Ronit Katz, Leonard Goldenstein, Mark J Sarnak, Andrew N Hoofnagle, David S Siscovick, Bryan Kestenbaum, Ian H de Boer, Joachim H Ix

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02743650 (Pilot Study of Sodium Bicarbonate in Generally Healthy People With Low Bicarbonate), which is not on this map. Cited by 52 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 3 pooled it
7.4field-weighted citation impact, top 2% of its field
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.

NCT02743650 naterminatednot on this mapstarted 2016, after this paper: background citation

Pilot Study of Sodium Bicarbonate in Generally Healthy People With Low Bicarbonate

TypeinterventionalSponsorUniversity of UtahRan2016 to 2017Enrolled7ConditionsChronic Kidney DiseaseArmsSodium bicarbonate
3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 94 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Todd H DriverSchool of Medicine, University of California, San Francisco.
Michael G ShlipakDepartment of Medicine, University of California, San Francisco; Department of Epidemiology and Biostatistics, University of California, San Francisco; Department of General Internal Medicine, San Francisco VA Medical Center, San Francisco, CA.
Ronit KatzKidney Research Institute, Division of Nephrology, University of Washington, Seattle, WA.
Leonard GoldensteinDivision of Nephrology and Hypertension, Department of Medicine, University of California, San Diego, CA.
Mark J SarnakDivision of Nephrology, Tufts Medical Center, Boston, MA.
Andrew N HoofnagleKidney Research Institute, Division of Nephrology, University of Washington, Seattle, WA.
David S SiscovickKidney Research Institute, Division of Nephrology, University of Washington, Seattle, WA; Cardiovascular Health Research Unit, University of Washington, Seattle, WA; Department of Medicine, University of Washington, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA.
Bryan KestenbaumKidney Research Institute, Division of Nephrology, University of Washington, Seattle, WA.
Ian H de BoerKidney Research Institute, Division of Nephrology, University of Washington, Seattle, WA.
Joachim H IxDivision of Nephrology and Hypertension, Department of Medicine, University of California, San Diego, CA; Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, CA; Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, CA. Electronic address: joeix@ucsd.edu.
University of Washington · USUniversity of California, San Diego · USUniversity of California, San Francisco · USTufts Medical Center · US

Funding

Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR024156 · NCRR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2006 to 2011
$53.0M
PILOT STUDY--CLINICAL NUTRITION RESEARCHP30DK035816 · NIDDK · UNIVERSITY OF WASHINGTON · PI GREGORY J MORTON · 1986 to 2026
$30.4M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
The Aging Kidney: Chronic Injury, Impaired Functions and Clinical OutcomesR01AG027002 · NIA · TUFTS MEDICAL CENTER · PI PARIKH, SAMIR M, SARNAK, MARK J · 2005 to 2022
$7.3M
Kidney Tubular Damage and Dysfunction Identify a Novel Axis of Chronic Kidney DiseaseR01DK098234 · NIDDK · VETERANS MEDICAL RESEARCH FDN/SAN DIEGO · PI IX, JOACHIM H, SHLIPAK, MICHAEL G · 2014 to 2023
$5.6M
Phosphorus and Vitamin D Metabolism and Cardiovascular Outcomes: The multi-ethniR01HL096875 · NHLBI · UNIVERSITY OF WASHINGTON · PI DE BOER, IAN H, KESTENBAUM, BRYAN R · 2010 to 2019
$5.2M
Cigarette Smoke and Susceptibility to Influenza InfectionR01HL095163 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI JASPERS, ILONA, NOAH, TERRY L · 2009 to 2013
$2.0M
Adjunctive Use of Apyrase to Fibrinolytic TherapyR44HL095169 · NHLBI · APT THERAPEUTICS, INC. · PI CHEN, RIDONG · 2012 to 2013
$1.3M
SUBCLINICAL CARDIOVASCULAR DISEASE STUDYN01HC095166 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1999 to 2001
$758k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-FIELD CENTERN01HC095162 · HC · JOHNS HOPKINS UNIVERSITY · PI SZKLO, MOYSES A · 1999 to 2000
$694k
Clinical and Transtional Science InstituteTL1TR000144 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$643k
NCATS NIH HHS TL1 TR000144NCATS NIH HHS UL1-TR-000040NCATS NIH HHS UL1-TR-001079NCRR NIH HHS UL1 RR024156NCRR NIH HHS UL1-RR-024156NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS N01-HC-95159NHLBI NIH HHS N01-HC-95160NHLBI NIH HHS N01-HC-95161NHLBI NIH HHS N01-HC-95162NHLBI NIH HHS N01-HC-95163NHLBI NIH HHS N01-HC-95164NHLBI NIH HHS N01-HC-95165NHLBI NIH HHS N01-HC-95166NHLBI NIH HHS N01-HC-95167NHLBI NIH HHS N01-HC-95168NHLBI NIH HHS N01-HC-95169NHLBI NIH HHS R01 HL096875NIA NIH HHS 5R01AG027002-07NIA NIH HHS R01 AG027002NIDDK NIH HHS 1R01DK098234-01A1NIDDK NIH HHS P30 DK035816NIDDK NIH HHS R01 DK098234
6 · The paper itself

Abstract

backgroundAmong populations with established chronic kidney disease (CKD), metabolic acidosis is associated with more rapid progression of kidney disease. The association of serum bicarbonate concentrations with early declines in kidney function is less clear. STUDY

designRetrospective cohort study. SETTING &

participants5,810 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with a baseline estimated glomerular filtration rate (eGFR) > 60mL/min/1.73 m(2) using the CKD-EPI (CKD Epidemiology Collaboration) creatinine-cystatin C equation. PREDICTORS: Serum bicarbonate concentrations. OUTCOMES: Rapid kidney function decline (eGFR decline > 5% per year) and incident reduced eGFR (eGFR < 60mL/min/1.73 m(2) with minimum rate of eGFR loss of 1 mL/min/1.73 m(2) per year).

resultsAverage bicarbonate concentration was 23.2 ± 1.8mEq/L. 1,730 (33%) participants had rapid kidney function decline, and 487 had incident reduced eGFR during follow-up. Each 1-SD lower baseline bicarbonate concentration was associated with 12% higher adjusted odds of rapid kidney function decline (95% CI, 6%-20%) and higher risk of incident reduced eGFR (adjusted incidence rate ratio, 1.11; 95% CI, 1.03-1.20) in models adjusting for demographics, baseline eGFR, albuminuria, and CKD risk factors. The OR for the associations of bicarbonate level < 21 mEq/L relative to 23-24 mEq/L was 1.35 (95% CI, 1.05-1.73) for rapid kidney function decline, and the incidence rate ratio was 1.16 (95% CI, 0.83-1.62) for incident reduced eGFR. LIMITATIONS: Cause of metabolic acidosis cannot be determined in this study.

conclusionsLower serum bicarbonate concentrations are associated independently with rapid kidney function decline independent of eGFR or albuminuria in community-living persons with baseline eGFR > 60 mL/min/1.73 m(2). If confirmed, our findings suggest that metabolic acidosis may indicate either early kidney disease that is not captured by eGFR or albuminuria or may have a causal role in the development of eGFR < 60 mL/min/1.73 m(2).

Indexed as

Renal Insufficiency, ChronicAcidosisAgedAlbuminuriaAtherosclerosisBicarbonatesCohort StudiesCreatinineCystatin CDisease ProgressionEthnicityFemaleGlomerular Filtration RateHumansKidney Function TestsMaleBicarbonatesCreatinineCystatin Cchronic kidney disease (CKD)disease progressionkidney disease trajectorykidney functionmetabolic acidosisrenal diseaseSerum bicarbonate

Identifiers

PMID24953891
PMCPMC4177290
OpenAlexW2035073281

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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.