ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1494

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

Session Information

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
  • Larive, Brett, Cleveland Clinic, Cleveland, Ohio, United States
  • Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Ix, Joachim H., University of California San Diego, La Jolla, California, United States
  • Wolf, Myles, Duke University School of Medicine, Durham, North Carolina, United States
  • Raj, Dominic S., George Washington University Medical Faculty Associates, Washington, District of Columbia, United States
  • Mendley, Susan R., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States
  • Fried, Linda F., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Kendrick, Cynthia A., Cleveland Clinic, Cleveland, Ohio, United States
  • Gassman, Jennifer J., Cleveland Clinic, Cleveland, Ohio, United States
  • Wesson, Donald E., Baylor Scott and White Health, Dallas, Texas, United States
  • Cheung, Alfred K., University of Utah Health, Salt Lake City, Utah, United States

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