Oral bicarbonate therapy resulted in a slightly higher estimated glomerular filtration rate (mean difference 3.1 mL/min per 1.73 m2; 95% CI 1.3-4.9) compared to placebo or conventional treatment.
Meta-Analysis (n=815)
Does oral bicarbonate therapy improve eGFR and serum bicarbonate levels in adults with non-haemodialysis dependent CKD?
Oral bicarbonate therapy in non-haemodialysis dependent CKD patients may slightly improve eGFR and serum bicarbonate levels, though long-term benefits remain uncertain.
Mean Difference: 3.1 (95% CI 1.3–4.9)
Metabolic acidosis is a common complication in chronic kidney disease (CKD) patients, and is associated with an accelerated decline in renal function. Oral bicarbonate therapy has been used to counteract metabolic acidosis in CKD for decades. However, until recently, there have been very few intervention studies testing the effectiveness of bicarbonate therapy at improving metabolic acidosis or its consequences in patients with CKD. In this systematic review and meta-analysis, we aimed to examine the outcomes of all published randomised controlled trials (RCTs) that investigated the effect of oral bicarbonate therapy in adults with CKD. Ovid MEDLINE®, EMBASE® and Cochrane Library were searched in mid-October 2018 for English literature, with no restrictions applied to the publication status or date. Seven RCTs that recruited 815 participants met our inclusion criteria after full text review. Oral bicarbonate supplementation resulted in a slightly higher estimated glomerular filtration rate (eGFR) (mean difference 3.1 mL/min per 1.73 m2; 95% CI 1.3–4.9) and serum bicarbonate levels (mean difference 3.4 mmol/L; 95% CI 1.9–4.9) at the end of follow-up (three months to five years) compared to those given placebo or conventional CKD treatment. When limited to studies reporting outcomes at one year, the positive effect of oral bicarbonate therapy on eGFR was attenuated. There were no significant treatment effects in other parameters such as systolic blood pressure (BP) and weight. These findings should be interpreted with caution and further trial evidence is needed to establish the net overall benefit or harm of oral bicarbonate therapy in CKD.
Hu et al. (Thu,) conducted a meta-analysis in Chronic kidney disease (CKD) (n=815). Oral bicarbonate therapy vs. Placebo or conventional CKD treatment was evaluated on Estimated glomerular filtration rate (eGFR) (MD 3.1, 95% CI 1.3-4.9). Oral bicarbonate therapy resulted in a slightly higher estimated glomerular filtration rate (mean difference 3.1 mL/min per 1.73 m2; 95% CI 1.3-4.9) compared to placebo or conventional treatment.