Why the study?
Although sodium bicarbonate is extensively used for metabolic acidosis in CKD, its efficacy on renal function indices had not been summarized in previous review studies.
Does oral sodium bicarbonate improve renal function indices in patients with chronic kidney disease?
Meta-Analysis (n=1,973)
Does oral sodium bicarbonate improve renal function indices in patients with chronic kidney disease?
Mean Difference: 0.75 (95% CI 0.14–1.35)
Oral sodium bicarbonate supplementation significantly improves renal function indices in patients with chronic kidney disease, potentially ameliorating disease progression.
Sodium bicarbonate may slow renal decline in acidotic CKD; reinforces trial evidence while leaving hard-outcome confirmation open.
Background Metabolic acidosis is a prevalent condition in patients with chronic kidney disease (CKD). Although sodium bicarbonate is extensively used for management of metabolic acidosis, its efficacy has not been summarized in previous review studies. Objective To conduct a systematic review and meta-analysis to estimate the overall effects of sodium bicarbonate on indices of renal function in patients with CKD. Methods A systematic literature search was carried out through the Medline, Web of Science and Scopus databases, up to July 2020. Studies that reported the effects of oral sodium bicarbonate administration on renal function were included. Blood urea nitrogen (BUN), serum creatinine, glomerular filtration rate (GFR), and creatinine clearance were defined as renal function indices. A random-effects model was used to calculate the overall effect and reported as weighted mean difference (WMD). Results Thirteen studies were included in this systematic review and meta-analysis. A beneficial effect of sodium bicarbonate was observed on BUN (WMD: − 8.63 mg/dL; 95% CI: -11.08, -6.19), serum creatinine (WMD: -0.19 mg/dL; 95% CI: -0.36, -0.02), GFR (WMD: 0.75 ml/min/1.73 m 2 ; 95% CI: 0.14, 1.35), and creatinine clearance (WMD: 4.82 mL/min; 95% CI: 2.68, 6.96). There was no between study heterogeneity for all renal function indices. Also, no publication bias was observed in this study. Conclusion This systematic review and meta-analysis showed that sodium bicarbonate supplementation could increase GFR and creatinine clearance and decrease BUN and creatinine. Therefore, sodium bicarbonate therapy may efficacious in ameliorating the progression of CKD.
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Tavassoly et al. (2021) conducted a meta-analysis in Chronic kidney disease (n=1,973). Oral sodium bicarbonate vs. Placebo or standard care was evaluated on Glomerular filtration rate (GFR) (WMD 0.75, 95% CI 0.14, 1.35).
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