ArticleClinical journal of the American Society of Nephrology : CJASN2016
Bicarbonate Concentration, Acid-Base Status, and Mortality in the Health, Aging, and Body Composition Study.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers.
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Who cites it
46 citing papers in PubMed, 79 citations in OpenAlex.
- Trial
- Serum bicarbonate concentration and the risk of death in type 2 diabetes: the Fremantle Diabetes Study Phase II.Acta diabetologica · 2023Trial
- Serum bicarbonate and cardiovascular events in hypertensive adults: results from the Systolic Blood Pressure Intervention Trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020Trial
- Toll of Chronic Metabolic Acidosis at Molecular, Cellular, and Systemic Levels: A Conceptual Framework to Revisit Type 2 Diabetes (T2D) Pathophysiology.Biomedicines · 2026Review
- Hypocapnia in acute carbon monoxide poisoning: A complex interaction beyond metabolic compensation.PloS one · 2026Article
- Observational
- Development and validation of a nomogram for predicting in-hospital mortality of patients with cervical spine fractures without spinal cord injury.European journal of medical research · 2024Article
- Acetic Acid: An Underestimated Metabolite in Ethanol-Induced Changes in Regulating Cardiovascular Function.Antioxidants (Basel, Switzerland) · 2024Review
- Effects of extracellular metabolic acidosis and out-of-equilibrium COFrontiers in physiology · 2024Article
- Association between base excess and 28-day mortality in sepsis patients: A secondary analysis based on the MIMIC- IV database.Heliyon · 2023Article
- Low Serum Bicarbonate Levels Increase the Risk of All-Cause, Cardiovascular Disease, and Cancer Mortality in Type 2 Diabetes.The Journal of clinical endocrinology and metabolism · 2022Article
- Diagnosing metabolic acidosis in chronic kidney disease: importance of blood pH and serum anion gap.Kidney research and clinical practice · 2022Article
- Metabolic acidosis post kidney transplantation.Frontiers in physiology · 2022Review
- Base excess is associated with the risk of all-cause mortality in critically ill patients with acute myocardial infarction.Frontiers in cardiovascular medicine · 2022Article
- Acidosis, cognitive dysfunction and motor impairments in patients with kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Review
- Role of the renal androgen receptor in sex differences in ammonia metabolism.American journal of physiology. Renal physiology · 2021Article
- FGF23 and Cause-Specific Mortality in Community-Living Individuals-The Health, Aging, and Body Composition Study.Journal of the American Geriatrics Society · 2021Article
- Low serum total COScientific reports · 2021Article
- Admission Serum Bicarbonate Predicts Adverse Clinical Outcomes in Hospitalized Cirrhotic Patients.Canadian journal of gastroenterology & hepatology · 2021Article
- Veverimer: an advance in base therapy for metabolic acidosis.Annals of translational medicine · 2020Article
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13 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesLow serum bicarbonate associates with mortality in CKD. This study investigated the associations of bicarbonate and acid-base status with mortality in healthy older individuals. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We analyzed data from the Health, Aging, and Body Composition Study, a prospective study of well functioning black and white adults ages 70-79 years old from 1997. Participants with arterialized venous blood gas measurements (n=2287) were grouped into <23.0 mEq/L (low), 23.0-27.9 mEq/L (reference group), and ≥28.0 mEq/L (high) bicarbonate categories and according to acid-base status. Survival data were collected through February of 2014. Mortality hazard ratios (HRs; 95% confidence intervals [95% CIs]) in the low and high bicarbonate groups compared with the reference group were determined using Cox models adjusted for demographics, eGFR, albuminuria, chronic obstructive pulmonary disease, smoking, and systemic pH. Similarly adjusted Cox models were performed according to acid-base status.
resultsThe mean age was 76 years, 51% were women, and 38% were black. Mean pH was 7.41, mean bicarbonate was 25.1 mEq/L, 11% had low bicarbonate, and 10% had high bicarbonate. Mean eGFR was 82.1 ml/min per 1.73 m(2), and 12% had CKD. Over a mean follow-up of 10.3 years, 1326 (58%) participants died. Compared with the reference group, the mortality HRs were 1.24 (95% CI, 1.02 to 1.49) in the low bicarbonate and 1.03 (95% CI, 0.84 to 1.26) in the high bicarbonate categories. Compared with the normal acid-base group, the mortality HRs were 1.17 (95% CI, 0.94 to 1.47) for metabolic acidosis, 1.21 (95% CI, 1.01 to 1.46) for respiratory alkalosis, and 1.35 (95% CI, 1.08 to 1.69) for metabolic alkalosis categories. Respiratory acidosis did not associate with mortality.
conclusionsIn generally healthy older individuals, low serum bicarbonate associated with higher mortality independent of systemic pH and potential confounders. This association seemed to be present regardless of whether the cause of low bicarbonate was metabolic acidosis or respiratory alkalosis. Metabolic alkalosis also associated with higher mortality.
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