Evidence map›Paper›PMID 31196951›Full record

SynthesisClinical journal of the American Society of Nephrology : CJASN2019

Effects of Treatment of Metabolic Acidosis in CKD: A Systematic Review and Meta-Analysis.

Sankar D Navaneethan, Jun Shao, Jerry Buysse, David A Bushinsky

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 6 pooled it
10.8field-weighted citation impact, top 1% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 6 syntheses or guidelines pooled it, 127 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Effects of dietary interventions for metabolic acidosis in chronic kidney disease: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Effects of Treatment of Metabolic Acidosis in CKD: A Systematic Review and Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2019
    Pooled it
  7. 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
    Trial
  8. Trial
  9. Trial
  10. Trial
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  12. Association between serum bicarbonate and low mid-upper arm circumference in patients with non-dialysis-dependent chronic kidney disease: A cross-sectional study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Soft tissue calcifications in chronic kidney disease-beyond the vasculature.Pflugers Archiv : European journal of physiology · 2025
    Review
  20. Article

7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Sankar D NavaneethanSection of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
Jun ShaoTricida, Inc., South San Francisco, CA; and.
Jerry BuysseTricida, Inc., South San Francisco, CA; and.
David A BushinskyDivision of Nephrology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Baylor College of Medicine · USUniversity of Rochester · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesMetabolic acidosis is associated with progression of CKD and has significant adverse effects on muscle and bone. A systematic review and meta-analysis was conducted to evaluate the benefits and risks of metabolic acidosis treatment with oral alkali supplementation or a reduction of dietary acid intake in those with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: MEDLINE, Embase, and Cochrane CENTRAL were searched for relevant trials in patients with stage 3-5 CKD and metabolic acidosis (<22 mEq/L) or low-normal serum bicarbonate (22-24 mEq/L). Data were pooled in a meta-analysis with results expressed as weighted mean difference for continuous outcomes and relative risk for categorical outcomes with 95% confidence intervals (95% CIs), using a random effects model. Study quality and strength of evidence were assessed using Cochrane risk of bias and the Grading of Recommendations Assessment, Development and Evaluation criteria.

resultsFourteen clinical trials were included (

conclusionsLow-to-moderate certainty evidence suggest that oral alkali supplementation or a reduction in dietary acid intake may slow the rate of kidney function decline and potentially reduce the risk of ESKD in patients with CKD and metabolic acidosis.

Indexed as

AcidosisAlkaliesBicarbonatesHumansKidney Failure, ChronicRenal Insufficiency, ChronicAlkaliesBicarbonatesacidosisAlbuminsAlkaliesAntihypertensive AgentsBiasBicarbonateschronic metabolic acidosisConfidence Intervalsglomerular filtration ratehypertensionkidney diseaseKidney Failure, ChronicRenal Insufficiency, ChronicRisk Assessmentsodium bicarbonate

Identifiers

PMID31196951
PMCPMC6625635
OpenAlexW2949470266

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.