Abstract: TH-PO1106
Oral Alkalinizing Drugs and Improvement of Intrarenal Oxidative Stress or Blood Flow in Mild-Stage CKD: A Randomized Cohort Study
Session Information
- CKD: Therapies, Innovations, and Insights
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Abe, Michiaki, Tohoku Daigaku Byoin, Sendai, Miyagi Prefecture, Japan
- Miyazaki, Mariko, Tohoku Daigaku Byoin, Sendai, Miyagi Prefecture, Japan
- Tanaka, Tetsuhiro, Tohoku Daigaku Byoin, Sendai, Miyagi Prefecture, Japan
- Abe, Takaaki, Tohoku Daigaku Byoin, Sendai, Miyagi Prefecture, Japan
Background
The beneficial effects of oral supplements with alkalinizing agents in patients with chronic kidney disease (CKD) have been limited to the severe stages. We investigated whether two types of supplements, sodium bicarbonate (SB) and potassium citrate/sodium citrate (PCSC), could maintain renal function in patients with mild-stage CKD.
Methods
This was a single-center, open-labeled, randomized cohort trial. Study participants with CKD stages G2, G3a, and G3b were enrolled between March 2013 and January 2019 and randomly assigned by stratification according to age, sex, estimated glomerular filtration rate (eGFR), and diabetes. They were followed up for 6 months (short-term study) for the primary endpoints and extended to 2 years (long-term study) for the secondary endpoints. Supplementary doses were adjusted to achieve an early morning urinary pH of 6.8–7.2. We observed renal dysfunction or new-onset cerebrovascular disease, evaluated urinary surrogate markers for renal injury and intrarenal vascular circulation.
Results
The registered patients were allocated to three groups: standard (n=35), SB (n=32), and PCSC (n=34). Two patients in the standard group attained the primary endpoints (renal stones and overt proteinuria). SB increased proteinuria (p=0.0139) but reduced interlobular arterial resistive index (p=0.0386). PCSC reduced urinary excretion of 8OHdG (p=0.0481).
Conclusion
PCSC improved intrarenal oxidative stress and SB improved intrarenal blood flow in patients with mild-stage CKD.