The Effect of Dialysate Bicarbonate Concentration or Oral Bicarbonate Supplementation on Outcomes in Patients on Maintenance Dialysis: A Systematic Review and Meta-Analysis
Systematic review evaluates outcomes of bicarbonate concentration and supplementation in dialysis patients, suggesting further research is needed.
Key Points
No significant differences in mortality or hospitalizations were noted in patients on maintenance dialysis, indicating treatment approaches may need reevaluation.
A meta-analysis showed a mean difference of 3.5 mmol/L in pre-dialysis serum bicarbonate for different bicarbonate concentrations, but the clinical relevance is uncertain.
The reviewed studies primarily consisted of small observational trials, highlighting a need for larger, high-quality randomized controlled trials to improve understanding.
Findings from studies on cardiovascular outcomes were inconsistent, adding to the uncertainty regarding the impact of bicarbonate supplementation strategies.