Why the study?
Does an acute oral NaHCO3 bolus reveal higher acid retention in subjects with moderately reduced eGFR compared to normal eGFR?
Does an acute oral NaHCO3 bolus reveal higher acid retention in subjects with moderately reduced eGFR compared to normal eGFR?
The authors propose using an acute oral NaHCO3 bolus to detect acid retention in patients with early CKD before plasma acid-base parameters become abnormal.
tions about our recent publication in the American Journal of Physiology-Renal Physiology (12) that interprets its data as supporting that humans with reduced estimated glomerular filtration rate (eGFR) have acid retention, detected using indi-rect techniques, that is not evident by plasma acid-base param-eters. We assessed the presence of acid retention by giving subjects an acute oral NaHCO3 bolus, 0.5 mg/kg body wt, then measured subsequent 8-h urine net acid excretion (8h NAE). We surmised that higher urine NAE after an NaHCO3 bolus would indicate higher acid retention in subjects with moder-ately reduced [CKD stage 2 (60–90 ml/min) eGFR or CKD 2] compared with normal [CKD stage 1 (90 ml/min) eGFR or CKD 1] eGFR, each without metabolic acidosis by plasma acid-base parameters. We surmised that more of the adminis-tered HCO3 would be titrated to CO2 and H2O by the hypoth-
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Donald E. Wesson (2011) conducted a letter in Reduced estimated glomerular filtration rate (CKD stage 2). Acute oral NaHCO3 bolus vs. Normal eGFR (CKD stage 1) was evaluated on 8-h urine net acid excretion (8h NAE).
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