Key result
Baseline base excess <-2.5 in patients with stage 3-5 CKD was associated with increased CKD progression (53% vs 32%) and renal replacement therapy requirement (35% vs 15%).
Why the study?
Metabolic acidosis commonly occurs during chronic kidney disease, prompting investigation into whether base excess, anion gap, and delta ratio associate with CKD progression, renal replacement therapy requirement, and mortality.
Does low baseline base excess predict CKD progression, RRT requirement, and mortality in outpatients with stage 3-5 CKD?
Cohort (n=212)
Does low baseline base excess predict CKD progression, RRT requirement, and mortality in outpatients with stage 3-5 CKD?
Odds Ratio: 0.38 (95% CI 0.16–0.91)
Absolute Event Rate: 35% vs 15%
p-value: p=<0.05
Low base excess levels are associated with an increased risk of CKD progression and the requirement for renal replacement therapy in patients with stage 3-5 CKD.
Objectives Metabolic acidosis is a common disorder seen in course of chronic kidney disease (CKD). In this study, we aimed to investigate the association of Base excess (BE), Anion gap (AG) and Delta Ratio with progression of CKD, renal replacement therapy (RRT) requirement and mortality in patients with stage 3–5 CKD. Methods A total of 212 patients with stage 3–5 CKD were included in this study. Patients were divided into two groups according to the baseline BE level. Patients were also grouped according to the delta ratio such as non- AG, High AG and mixed type. Results Mean BE level was significantly lower (−4.7 ± 4.0 vs. −3.3 ± 4.3; p=0.02) in patients with CKD progression. The patients in group 1 (n: 130) (Be<−2.5) revealed more CKD progression (%53 vs. %32; p=0.002), and RRT requirement (%35 vs. %15; p=0.001). Baseline BE <−2.5 (odds ratio, 0.38; 95% CI, 0.16 to 0.91; p<0.05) and baseline GFR (odds ratio, 0.94; 95% CI, 0.90 to 0.97; p<0.001) were independently related to RRT requirement. Delta BE was independently associated with mortality (odds ratio, 0.90; 95% CI, 0.85–0.96; p<0.01). Conclusions Low BE levels were associated with CKD progression and RRT requirement. BE change is associated with mortality during the follow-up of those patients.
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Bozacı et al. (2020) conducted a cohort in Stage 3-5 chronic kidney disease (n=212). Baseline base excess < -2.5 vs. Baseline base excess ≥ -2.5 was evaluated on Renal replacement therapy (RRT) requirement (OR 0.38, 95% CI 0.16-0.91, p=<0.05). Baseline base excess <-2.5 in patients with stage 3-5 CKD was associated with increased CKD progression (53% vs 32%) and renal replacement therapy requirement (35% vs 15%).
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