Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2021
Effect of Bicarbonate on Net Acid Excretion, Blood Pressure, and Metabolism in Patients With and Without CKD: The Acid Base Compensation in CKD Study.
Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02427594 (Acid-Base Compensation in Chronic Kidney Disease), which is not on this map. Cited by 13 papers.
What it found
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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.
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.
Acid-Base Compensation in Chronic Kidney Disease: Measurement and Physiologic Impact
Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Interpretation of Pharmacometabolomics Results: Fingerprint of Drug Exposure or Confounder Effects? Insights from a Urinary Metabolomics Study with Voriconazole in Healthy Participants.International journal of molecular sciences · 2026Trial
- Urine tricarboxylic acid cycle signatures of early-stage diabetic kidney disease.Metabolomics : Official journal of the Metabolomic Society · 2021Trial
- Trial
- Nuclear Magnetic Resonance-Based Urinary Metabolic Profiling for Assessing Heat Stress-Related Incident Kidney Injury in Health-Care Workers.GeoHealth · 2026Article
- Mutations in ammonia transporter RhBG that impair NHThe Journal of physiology · 2026Article
- Metabolic Acidosis in Patients with Chronic Kidney Disease: Diagnosis, Pathogenesis, and Treatment-A Narrative Review.Diagnostics (Basel, Switzerland) · 2025Review
- Hydration Meets Regulation: Insights into Bicarbonate Mineral Water and Acid-Base Balance.Nutrients · 2025Review
- Acute perioperative alterations in metabolism: A pilot study using mass spectrometry-based metabolomics.Surgery · 2025Article
- A Urine pH-Ammonium Acid/Base Score and CKD Progression.Journal of the American Society of Nephrology : JASN · 2024Article
- Acid-Base Balance in Healthy Adults: Beneficial Effects of Bicarbonate and Sodium-Rich Mineral Water in a Randomized Controlled Trial: The BicarboWater Study.Journal of nutrition and metabolism · 2024Article
- Diversity of plant DNA in stool is linked to dietary quality, age, and household income.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Hidden Acid Retention with Normal Serum Bicarbonate Level in Chronic Kidney Disease.Electrolyte & blood pressure : E & BP · 2023Review
- Sugar-sweetened beverage consumption and mortality of chronic kidney disease: results from the US National Health and Nutrition Examination Survey, 1999-2014.Clinical kidney journal · 2022Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectivePatients with CKD are at elevated risk of metabolic acidosis due to impaired net acid excretion (NAE). Identifying early markers of acidosis may guide prevention in chronic kidney disease (CKD). This study compared NAE in participants with and without CKD, as well as the NAE, blood pressure (BP), and metabolomic response to bicarbonate supplementation. STUDY
designRandomized order, cross-over study with controlled feeding. SETTING &
participantsParticipants consisted of 8 patients with CKD (estimated glomerular filtration rate 30-59mL/min/1.73m
interventionParticipants were fed a fixed-acid-load diet with bicarbonate supplementation (7 days) and with sodium chloride control (7 days) in a randomized order, cross-over fashion. OUTCOMES: Urine NAE, 24-hour ambulatory BP, and 24-hour urine and plasma metabolomic profiles were measured after each period.
resultsDuring the control period, mean NAE was 28.3±10.2 mEq/d overall without differences across groups (P=0.5). Urine pH, ammonium, and citrate were significantly lower in CKD than in non-CKD (P<0.05 for each). Bicarbonate supplementation reduced NAE and urine ammonium in the CKD group, increased urine pH in both groups (but more in patients with CKD than in those without), and increased; urine citrate in the CKD group (P< 0.2 for interaction for each). Metabolomic analysis revealed several urine organic anions were increased with bicarbonate in CKD, including 3-indoleacetate, citrate/isocitrate, and glutarate. BP was not significantly changed. LIMITATIONS: Small sample size and short feeding duration.
conclusionsCompared to patients without CKD, those with CKD had lower acid excretion in the form of ammonium but also lower base excretion such as citrate and other organic anions, a potential compensation to preserve acid-base homeostasis. In CKD, acid excretion decreased further, but base excretion (eg, citrate) increased in response to alkali. Urine citrate should be evaluated as an early and responsive marker of impaired acid-base homeostasis.
fundingNational Institute of Diabetes and Digestive and Kidney Diseases and the Duke O'Brien Center for Kidney Research.
trial registrationRegistered at ClinicalTrials.gov with study number NCT02427594.
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Registered trials
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