ArticleKidney medicine
Metabolic Acidosis and Cardiovascular Disease in CKD.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 30 citations in OpenAlex.
- Assessment and treatment of metabolic acidosis in CKD: a registry-based study.Scientific reports · 2026Article
- The prognostic value of albumin-corrected anion gap for major adverse cardiac events in chronic kidney disease patients undergoing percutaneous coronary intervention.Frontiers in cardiovascular medicine · 2026Article
- Epac2 Deficiency Compromises Adaptation to Dietary Acidification by Decreasing H+ Transport in the Renal Nephron.Function (Oxford, England) · 2025Article
- Effect of spironolactone on cardiovascular and renal outcomes in patients with chronic kidney disease.Clinical kidney journal · 2025Article
- Metabolic Acidosis in Patients with Chronic Kidney Disease: Diagnosis, Pathogenesis, and Treatment-A Narrative Review.Diagnostics (Basel, Switzerland) · 2025Review
- [Cardiorenal syndrome: causes, diagnosis and treatment of congestive nephropathy].Innere Medizin (Heidelberg, Germany) · 2025Review
- Acute Ischemic Stroke and Myocardial Infarction in a Patient Diagnosed WithCase reports in infectious diseases · 2025Article
- A predictive model based on serum bicarbonate for cardiovascular events after initiation of peritoneal dialysis.Renal failure · 2024Observational
- Association between delta anion gap/delta bicarbonate and outcome of surgical patients admitted to intensive care unit.BMC anesthesiology · 2024Observational
- Metabolic Acidosis in CKD: Pathogenesis, Adverse Effects, and Treatment Effects.International journal of molecular sciences · 2024Review
- Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members.Journal of the American Heart Association · 2024Article
- Article
- Aortic arch calcification increases major adverse cardiac event risk, modifiable by echocardiographic left ventricular hypertrophy, in end-stage kidney disease patients.Therapeutic advances in chronic disease · 2024Article
- Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association.Cardiovascular research · 2023Review
- Association of the Kidney Failure Risk Equation With High Health Care Costs.Kidney international reports · 2023Article
- Metabolic Acidosis and Adverse Outcomes and Costs in CKD: An Observational Cohort Study.Kidney medicine · 2023Article
- Endothelial Cell Dysfunction and Increased Cardiovascular Risk in Patients With Chronic Kidney Disease.Circulation research · 2023Review
- Article
- Serum Bicarbonate and Graft and Patient Outcomes Among Kidney Transplant Recipients: A Retrospective Cohort Study Evaluating Changes in Serum Bicarbonate Over Time.Kidney medicine · 2023Article
- Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
RATIONALE &
objectiveMetabolic acidosis related to chronic kidney disease (CKD) is associated with an accelerated decline in glomerular filtration rate (GFR) and the development of end-stage kidney disease. Whether metabolic acidosis is associated with cardiovascular (CV) events in patients with CKD is unclear. STUDY
designRetrospective cohort study. SETTING &
participantsThe Optum De-identified Electronic Health Records Dataset, 2007-2017, was used to generate a cohort of patients with non-dialysis-dependent CKD who had at least 3 estimated GFR < 60 mL/min/1.73 m PREDICTOR: Serum bicarbonate as a continuous variable. OUTCOME: Primary outcome was a composite of major adverse cardiovascular events (MACE+). Secondary outcomes included individual components of the composite outcome. ANALYTICAL APPROACH: Cox proportional hazards models to evaluate the association between 1-mEq/L increments in serum bicarbonate and MACE+.
resultsA total of 51,558 patients were evaluated, 34% had metabolic acidosis. The median follow-up period was 3.9-4.5 years, depending on the outcome assessed. The adjusted hazard ratio (HR) for MACE+ was 0.964 (95% CI, 0.961-0.968). For the individual components of incident heart failure (HF), stroke, myocardial infarction (MI), and CV death, HRs were 0.98 (95% CI, 0.97-0.98), 0.98 (95% CI, 0.97-0.99), 0.96 (95% CI, 0.96-0.97), and 0.94 (95% CI, 0.93-0.94), respectively, for every 1-mEq/L increase in serum bicarbonate. LIMITATIONS: Possible residual confounding.
conclusionsMetabolic acidosis in CKD is associated with an increased risk of MACE+ as well as the individual components of incident HF, stroke, MI, and CV death. Randomized controlled trials evaluating treatments for the correction of metabolic acidosis in CKD to prevent CV events are needed.
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Registered trials
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.