Evidence map›Paper›PMID 33382448›Full record

Trial reportJournal of nephrology2021

Effect of sodium bicarbonate supplementation on the renin-angiotensin system in patients with chronic kidney disease and acidosis: a randomized clinical trial.

Dominique M Bovée, Lodi C W Roksnoer, Cornelis van Kooten, Joris I Rotmans, Liffert Vogt, Martin H de Borst, Robert Zietse, A H Jan Danser, Ewout J Hoorn

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. Metabolic acidosis in chronic kidney disease: mere consequence or also culprit?Pflugers Archiv : European journal of physiology · 2024
    Review
  7. Article
  8. Kidney metabolism and acid-base control: back to the basics.Pflugers Archiv : European journal of physiology · 2022
    Review
  9. Article
  10. 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 · 2021
    Review
  11. Observational
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

9 authors at 4 institutions in 1 country.

Dominique M BovéeDivisions of Nephrology & Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Room Ns403, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
Lodi C W RoksnoerVascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Cornelis van KootenDepartment of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Joris I RotmansDepartment of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Liffert VogtSection of Nephrology, Department of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Martin H de BorstDivision of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Robert ZietseDivisions of Nephrology & Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Room Ns403, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
A H Jan DanserVascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Ewout J HoornDivisions of Nephrology & Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Room Ns403, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. e.j.hoorn@erasmusmc.nl.
Erasmus MC · NLLeiden University Medical Center · NLAmsterdam University Medical Centers · NLUniversity Medical Center Groningen · NL

Funding

Nierstichting 14OK19
6 · The paper itself

Abstract

backgroundAcidosis-induced kidney injury is mediated by the intrarenal renin-angiotensin system, for which urinary renin is a potential marker. Therefore, we hypothesized that sodium bicarbonate supplementation reduces urinary renin excretion in patients with chronic kidney disease (CKD) and metabolic acidosis.

methodsPatients with CKD stage G4 and plasma bicarbonate 15-24 mmol/l were randomized to receive sodium bicarbonate (3 × 1000 mg/day, ~ 0.5 mEq/kg), sodium chloride (2 × 1,00 mg/day), or no treatment for 4 weeks (n = 15/arm). The effects on urinary renin excretion (primary outcome), other plasma and urine parameters of the renin-angiotensin system, endothelin-1, and proteinuria were analyzed.

resultsForty-five patients were included (62 ± 15 years, eGFR 21 ± 5 ml/min/1.73m

conclusionsDespite correction of acidosis and reduction in urinary ammonium excretion, sodium bicarbonate supplementation did not improve urinary markers of the renin-angiotensin system, endothelin-1, or proteinuria. Possible explanations include bicarbonate dose, short treatment time, or the inability of urinary renin to reflect intrarenal renin-angiotensin system activity.

Indexed as

AcidosisRenal Insufficiency, ChronicDietary SupplementsHumansRenin-Angiotensin SystemSodium BicarbonateSodium BicarbonateAldosteroneClinical trialProteinuriaRenin

Identifiers

PMID33382448
PMCPMC8494695
OpenAlexW3115404350

What OpenQuestion holds

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LicenceCC BY
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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.