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CLINICAL RESEARCH
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Bicarbonate Supplementation Slows Progression of CKD and Improves Nutritional Status

Ione de Brito-Ashurst, Mira Varagunam, Martin J. Raftery and Muhammad M. Yaqoob
JASN September 2009, 20 (9) 2075-2084; DOI: https://doi.org/10.1681/ASN.2008111205
Ione de Brito-Ashurst
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Mira Varagunam
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Martin J. Raftery
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Muhammad M. Yaqoob
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    Figure 1.

    Participant enrollment and randomization to the study. Arm A (left column) allocated to oral bicarbonate and arm B (right colum) allocated to standard therapy.

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    Figure 2.

    (A) Plasma HCO3− levels during the study period. Squares and bars denote means and SD. (B) Urinary sodium (Na) excretion per day. Squares and bars denote means and SD. (C) BP control during the study period. Squares and bars denote means and SD. (D) Urinary total protein excretion per day during the study period. Squares and bars denote means and SD. (E) Rate of decline of CrCl. Squares and bars denote means and SD.

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    Figure 3.

    Kaplan-Meier analysis to assess the probability of reaching ESRD for the two groups.

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    Figure 4.

    (A) Dietary protein intake on 4-d patient dietary records. Data are means and SD. (B) nPNA during the study period. Data are means and SD. (C) MAMC measurements during the study period. Data are means and SD. (D) Plasma albumin levels in the control and bicarbonate groups during the study period. Data are means and SD. (E) Serum potassium levels in the control and bicarbonate groups during the study period. Data are means and SD.

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    Table 1.

    Baseline demographic characteristics of patientsa

    VariableControlBicarbonate
    Demographic
        age (yr; mean ± SE)54.77 ± 2.3454.78 ± 2.56
        male (%)5152
        white (%)5252
        black/Asian (%)4848
    Diagnosis (%)
        diabetes3637
        hypertension2629
        CRF unknown1410
        glomerulonephritis1310
        obstructive uropathy41
        other712
    Medications (%)
        loop diuretics6770
        moxonodine1517
        α blockers5759
        β blockers1719
        calcium channel blockers4850
        ACEIs/ARBs4850
        allopurinol30
    • ↵aCRF, chronic renal failure.

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    Table 2.

    Baseline characteristics of the study populationa

    VariableControlBicarbonateP
    Weight (kg)74.9 ± 11.576.6 ± 21.10.84
    Systolic BP (mmHg)123.7 ± 1.2124.0 ± 1.30.84
    Diastolic BP (mmHg)75.4 ± 1.976.1 ± 1.50.91
    MAMC (cm)24.8 ± 2.424.6 ± 2.90.81
    Albumin (g/L)35.1 ± 0.834.7 ± 0.50.76
    Bicarbonate (mmol/L)19.9 ± 1.519.8 ± 2.20.66
    CrCl (ml/min per 1.73 m2)20.70 ± 5.5520.12 ± 6.470.60
    Urinary Na (mmol/L)140.1 ± 4.4140.0 ± 7.90.96
    Urinary protein (g/24 h)1.8 ± 0.21.7 ± 0.80.84
    • ↵aData are means ± SE.

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    Table 3.

    Adverse events during the study perioda

    Adverse EventsControl (% of Patients)Bicarbonate (% of Patients)P
    Hospitalization for CHF00N/A
    Worsening hypertension requiring increase in therapy48610.17
    Worsening edema requiring increase in loop diuretics30390.5
    Bad taste requiring switch to powder form of sodium bicarbonateN/A6.5N/A
    • ↵aCHF, congestive heart failure.

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Journal of the American Society of Nephrology: 20 (9)
Journal of the American Society of Nephrology
Vol. 20, Issue 9
1 Sep 2009
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Bicarbonate Supplementation Slows Progression of CKD and Improves Nutritional Status
Ione de Brito-Ashurst, Mira Varagunam, Martin J. Raftery, Muhammad M. Yaqoob
JASN Sep 2009, 20 (9) 2075-2084; DOI: 10.1681/ASN.2008111205

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Bicarbonate Supplementation Slows Progression of CKD and Improves Nutritional Status
Ione de Brito-Ashurst, Mira Varagunam, Martin J. Raftery, Muhammad M. Yaqoob
JASN Sep 2009, 20 (9) 2075-2084; DOI: 10.1681/ASN.2008111205
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