ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2021
Serum bicarbonate is associated with kidney outcomes in autosomal dominant polycystic kidney disease.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Serum and urine prognostic biomarkers for autosomal dominant polycystic kidney disease: a systematic review and meta-analysis.BMC nephrology · 2026Pooled it
- Interventions for preventing the progression of autosomal dominant polycystic kidney disease.The Cochrane database of systematic reviews · 2024Pooled it
- Development and Validation of a Multivariable Prediction Model for Kidney Failure in Early Autosomal Dominant Polycystic Kidney Disease.Journal of the American Society of Nephrology : JASN · 2026Article
- Review
- Comparative validation of the Mayo Clinic imaging classification and PROPKD score for predicting ADPKD progression across diverse ethnic cohorts.Journal of nephrology · 2025Article
- Association of serum bicarbonate with 28-day and 90-day mortality in patients with epilepsy and concurrent sepsis: a retrospective cohort study.Frontiers in neurology · 2025Article
- Biomarkers of Kidney Disease Progression in ADPKD.Kidney international reports · 2024Review
- Trigger Warning: How Modern Diet, Lifestyle, and Environment Pull the Trigger on Autosomal Dominant Polycystic Kidney Disease Progression.Nutrients · 2024Review
- A combination of β-hydroxybutyrate and citrate ameliorates disease progression in a rat model of polycystic kidney disease.American journal of physiology. Renal physiology · 2024Article
- Progression to kidney failure in ADPKD: the PROPKD score underestimates the risk assessed by the Mayo imaging classification.Frontiers in medicine · 2024Article
- Predicting autosomal dominant polycystic kidney disease progression: review of promising Serum and urine biomarkers.Frontiers in pediatrics · 2023Review
- Sex distinctive patterns in the association between serum bicarbonate and uric acid levels among healthy adults. Qatar biobank data.Frontiers in medicine · 2023Article
- Urinary Citrate Is Associated with Kidney Outcomes in Early Polycystic Kidney Disease.Kidney360 · 2022Article
- Increased Body Fat and Organic Acid Anions Production Are Associated with Larger Kidney Size in ADPKD.Medicina (Kaunas, Lithuania) · 2022Article
- Change in Urinary Myoinositol/Citrate Ratio Associates with Progressive Loss of Renal Function in ADPKD Patients.American journal of nephrology · 2022Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMetabolic acidosis accelerates progression of chronic kidney disease, but whether this is also true for autosomal dominant polycystic kidney disease (ADPKD) is unknown.
methodsPatients with ADPKD from the DIPAK (Developing Interventions to halt Progression of ADPKD) trial were included [n = 296, estimated glomerular filtration rate (eGFR) 50 ± 11 mL/min/1.73 m2, 2.5 years follow-up]. Outcomes were worsening kidney function (30% decrease in eGFR or kidney failure), annual eGFR change and height-adjusted total kidney and liver volumes (htTKV and htTLV). Cox and linear regressions were adjusted for prognostic markers for ADPKD [Mayo image class and predicting renal outcomes in ADPKD (PROPKD) scores] and acid-base parameters (urinary ammonium excretion).
resultsPatients in the lowest tertile of baseline serum bicarbonate (23.1 ± 1.6 mmol/L) had a significantly greater risk of worsening kidney function [hazard ratio = 2.95, 95% confidence interval (CI) 1.21-7.19] compared with patients in the highest tertile (serum bicarbonate 29.0 ± 1.3 mmol/L). Each mmol/L decrease in serum bicarbonate increased the risk of worsening kidney function by 21% in the fully adjusted model (hazard ratio = 1.21, 95% CI 1.06-1.37). Each mmol/L decrease of serum bicarbonate was also associated with further eGFR decline (-0.12 mL/min/1.73 m2/year, 95% CI -0.20 to -0.03). Serum bicarbonate was not associated with changes in htTKV or htTLV growth.
conclusionsIn patients with ADPKD, a lower serum bicarbonate within the normal range predicts worse kidney outcomes independent of established prognostic factors for ADPKD and independent of urine ammonium excretion. Serum bicarbonate may add to prognostic models and should be explored as a treatment target in ADPKD.
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