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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


  • 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

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.


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.


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.


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


  • NIDDK Support