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: PO1493

The Real Life of Oral Alkalinization by Urologists and Nephrologists on Extracellular Volume: The AlcalUN Study

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

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

Authors

  • Bertocchio, Jean-philippe, University of Texas MD Anderson Cancer Center, Houston, United States
  • Moriniere beaume, Julie, Club des Jeunes Néphrologues, Paris, France
  • Figueres, Lucile, Club des Jeunes Néphrologues, Paris, France
  • Bobot, Mickaël, Club des Jeunes Néphrologues, Paris, France
  • Aubert, Olivier, Club des Jeunes Néphrologues, Paris, France
  • De laforcade, Louis, Club des Jeunes Néphrologues, Paris, France
  • Ayari, Hamza, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France
  • Dolley-Hitze, Thibault, Club des Jeunes Néphrologues, Paris, France
  • Gueutin, Victor, AURA Paris Plaisance, Paris, France
  • Braconnier, Antoine, Club des Jeunes Néphrologues, Paris, France
  • Golbin, Leonard, Club des Jeunes Néphrologues, Paris, France
  • Citarda, Salvatore, Club des Jeunes Néphrologues, Paris, France
  • Seret, Guillaume, ECHO Santé, Pôle Santé Sud, Le Mans, France
  • Belaid, Lisa, AUB Santé, Saint-Malo, France, Saint-Malo, France
  • Cohen, Raphael Rc, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France
  • Luque, Yosu, Club des Jeunes Néphrologues, Paris, France
  • Seervai, Riyad N. H., Center for Precision Envrionmental Health, Baylor College of Medicine, Houston, Texas, United States
  • Overs, Camille, Association des Urologues en Formation, Paris, Ile-de-France, France

Group or Team Name

  • AlcalUN study investigators
Background

Oral alkalinization with sodium bicarbonate (NaHCO3) or citrate is prescribed to treat conditions ranging from metabolic acidosis to nephrolithiasis. While most nephrologists/urologists use these treatments regularly, extracellular volume (ECV) increase is a main feared adverse event for NaHCO3 use. To date, no clinical trial has specifically addressed this aspect in clinical routine.

Methods

AlcalUN (NCT03035812) is a multi-center, prospective, open-label study aiming to assess the impact of a chronic oral alkalinization on ECV. Patients receiving oral alkalinization without NaHCO3 (citrate) comprised the control group. Increased ECV (primary outcome) was assessed based on body weight (BW), blood pressure (BP), and edema at first follow-up visit.

Results

From 02/2017 to 02/2020, 156 patients were enrolled (129 received NaHCO3, 27 citrate). Out of them, 127 (80%) participants had at least one follow-up visit. Normalizing for demographics, patients in the NaHCO3 group had higher incidence of chronic kidney disease (68 vs. 30%, p=0.002) and hypertension (75 vs. 35%, p=0.001), while patients in the No-NaHCO3 group (citrate) had more nephrolithiasis (95 vs. 28%, p<0.001). At baseline, BW, BP, and presence of edema were similar in both groups. After a median of 90 days of treatment, 91 (72%) patients reached the primary outcome, with similar distribution in both groups (71 vs. 75%, p=0.79). We found similar results after after propensity score matching.

Conclusion

Chronic oral alkalinization with NaHCO3 does not increase ECV more than citrate, even though it is used in a higher-risk population. These results confirm secondary outcomes from other trials, potentially highlighting the role of chloride load instead of sodium load.