Kidney Week

Abstract: PO1494

Effect of Sodium Bicarbonate on Kidney Injury: A Secondary Analysis of the BASE Pilot Trial

Session Information

• Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 2
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid, Electrolyte, and Acid-Base Disorders

• 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

• Raphael, Kalani L., University of Utah Health, Salt Lake City, Utah, United States

Kalani L. Raphael,

• Larive, Brett, Cleveland Clinic, Cleveland, Ohio, United States

Brett Larive,

• Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Tamara Isakova,

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix,

• Wolf, Myles, Duke University School of Medicine, Durham, North Carolina, United States

Myles Wolf,

• Raj, Dominic S., George Washington University Medical Faculty Associates, Washington, District of Columbia, United States

Dominic S. Raj,

• Mendley, Susan R., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Susan R. Mendley,

• Fried, Linda F., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States

Linda F. Fried,

• Kendrick, Cynthia A., Cleveland Clinic, Cleveland, Ohio, United States

Cynthia A. Kendrick,

• Gassman, Jennifer J., Cleveland Clinic, Cleveland, Ohio, United States

Jennifer J. Gassman,

• Wesson, Donald E., Baylor Scott and White Health, Dallas, Texas, United States

Donald E. Wesson,

• Cheung, Alfred K., University of Utah Health, Salt Lake City, Utah, United States

Alfred K. Cheung,

Group or Team Name

• CKD Pilot Studies Consortium

Background

NaHCO₃ is used to treat metabolic acidosis in CKD. In the Bicarbonate Administration to Stabilize eGFR (BASE) Pilot Trial, a dose-dependent increase in albuminuria was observed with NaHCO₃ over 28 weeks, suggesting that NaHCO₃ may promote kidney injury. We investigated the effect of NaHCO₃ on kidney tubule injury markers (KIM-1 and NGAL) in BASE participants.

Methods

Urinary KIM-1 and NGAL were measured in 176 BASE participants at baseline, week 12, and week 28. Change in urinary KIM-1/Cr and NGAL/Cr was compared within and between the three treatment groups (Placebo, n=49; Lower-Dose [0.5 meq/kg/d] NaHCO₃, n=48; and Higher-Dose [0.8 meq/kg/d] NaHCO₃, n=79) using linear mixed models.

Results

Mean±SD baseline values were: age 67±12 years, systolic BP 126±13 mm Hg, eGFR 36±9 ml/min/1.73m², serum tCO₂ 24±2 meq/L. Median (IQR) urinary values at baseline were: ACR 185 (24, 767) mg/g, KIM-1/Cr 0.88 (0.43, 1.36) ng/mg, and NGAL/Cr 14.3 (6.44, 34.0) ng/mg. At week 12, urinary KIM-1/Cr levels were not different from baseline in any group. However, at week 28, KIM-1/Cr levels were significantly lower in all three groups. NGAL/Cr was significantly higher in the Higher-Dose NaHCO₃ group at week 12; however, there were no other significant within group differences at week 12 or 28. In the between group comparisons, there were no significant differences in KIM-1/Cr (p≥0.16) or NGAL/Cr (p≥0.07) at either week 12 or 28.

Conclusion

Among BASE Pilot Trial participants, NaHCO₃ had no significant effect on urinary KIM-1/Cr or NGAL/Cr levels over 28 weeks.

Funding

• NIDDK Support