Kidney Week

Abstract: FR-PO635

Alkalinization by Urologists and Nephrologists (AlcalUN): Does Oral Sodium Bicarbonate (NaHCO₃) Affect Extracellular Volume?

Session Information

• Fluid and Electrolytes: Clinical - Acid-Base, Magnesium, Calcium, Phosphorus
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid and Electrolytes

• 902 Fluid and Electrolytes: Clinical

Authors

• Bertocchio, Jean-philippe, Club des Jeunes Néphrologues, Paris, France

Jean-philippe Bertocchio,

• Figueres, Lucile, Nantes University Hospital, Nantes, France

Lucile Figueres,

• De laforcade, Louis, Centre Hospitalier Pierre Oudot, Bourgoin-Jallieu, France

Louis De laforcade,

• Ayari, Hamza, AP-HP, European Georges Pompidou Hospital, Paris, France

Hamza Ayari,

• Dolley-Hitze, Thibault, AUB Santé, Saint-Malo, France

Thibault Dolley-Hitze,

• Gueutin, Victor, CHU Caen, Caen, France

Victor Gueutin,

• Golbin, Leonard, CHU Pontchaillou, Rennes, France

Leonard Golbin,

• Overs, Camille, Grenoble University Hospital, La Tronche, France

Camille Overs,

• Moriniere beaume, Julie, AVODD, Toulon, France

Julie Moriniere beaume,

Background

Oral alkalinization with NaHCO₃ or citrate is widely prescribed in numerous situations from metabolic acidosis to nephrolithiasis. Most of nephrologists/urologists use it on a regular basis, while extracellular volume (ECV) increase is the main feared adverse event for NaHCO₃. To date, no clinical trial has specifically studied this aspect in clinical routine.

Methods

AlcalUN (NCT03035812) is a French multicentric prospective open trial aiming at determining the impact on ECV of a chronic oral alkalinization by NaHCO₃ during nephrologists or urologists use. Patients receiving oral alkalinization without NaHCO₃ composed a control group. The main criterion was the ECV increase as judged on body weight (BW), blood pressure (BP), and edema at first visit.

Results

From 01/2017 to 12/2018, 20 investigators included 122 patients whom 92 (75%) had at least one follow-up and 74 (61%) received NaHCO₃. If both groups were comparable as judged on demographic data, patients in the NaHCO₃-group had more chronic kidney diseases (74 vs. 28%, p<0.001) where patients in the non NaHCO₃-group (citrate) had more nephrolithiasis (23 vs. 94%, p<0.001). At baseline (inclusion), BW, BP, and presence of edema were comparable in both groups. After a mean of 98±48 days of follow-up, 70 patients (76%) had an ECV increase but the repartition was highly similar in both groups (77 vs. 72%, p=0.76), especially BW did not differ (cf. Figure 1).

Conclusion

Oral alkalinization with NaHCO₃ does not increase ECV more than citrate while it is used in a more risky population. These results should be confirmed in a widest population (recruitment continues) and now in a randomized controlled trial.

Figure 1. Evolution of body weight between inclusion (V0) and first follow-up (V1).