Why the study?
Additional sodium loading from sodium bicarbonate treatment could worsen arterial hypertension in patients with CKD, an effect that has been under-studied in prospective trials.
Does high-dose oral sodium bicarbonate increase 24-hour ambulatory blood pressure in patients with chronic kidney disease and metabolic acidosis?
Population
47 patients with CKD
Comparison
High dose oral sodium bicarbonate vs rescue treatment if necessary
Design
Randomized controlled trial
Follow-up
8 weeks
Key result
Oral sodium bicarbonate supplementation over 8 weeks did not significantly increase systolic blood pressure measured by 24h-ABPM compared to rescue therapy in patients with chronic kidney disease (MD 2.522 mmHg).
Authors
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No BP increase on 24h-ABPM with sodium bicarbonate in CKD acidosis; supports safe use and extends RCT safety data.
RCT (n=47)
Open-label
Yes
No
Does high-dose oral sodium bicarbonate increase 24-hour ambulatory blood pressure in patients with chronic kidney disease and metabolic acidosis?
Mean Difference: 2.522 (95% CI -2.364–7.408)
Absolute Event Rate: 4.58% vs 2.1%
p-value: p=0.314
Sodium bicarbonate supplementation over 8 weeks did not significantly increase blood pressure measured by 24h-ABPM in patients with CKD and metabolic acidosis.
Gaggl et al. (2021) conducted an RCT in Chronic Kidney Disease and Metabolic Acidosis (n=47). Oral sodium bicarbonate vs. Rescue therapy (target serum HCO3- 20 ± 1 mmol/L) was evaluated on Change in systolic 24-hour ambulatory blood pressure from baseline to week 8 (MD 2.522, 95% CI -2.364 to 7.408, p=0.314). Oral sodium bicarbonate supplementation over 8 weeks did not significantly increase systolic blood pressure measured by 24h-ABPM compared to rescue therapy in patients with chronic kidney disease (MD 2.522 mmHg).