On Sunday, June 30, 2019 at 8:08:22 PM UTC-4,
col...@gmail.com wrote:
> More recently, a 5-year prospective, randomized, placebo-controlled blinded interventional study tested if daily oral sodium bicarbonate slowed GFR decline in patients with hypertensive nephropathy with reduced but relatively preserved estimated GFR (eGFR) (mean 75 ml/min per 1.73 m2). Participants matched for age, ethnicity, albuminuria, and eGFR received either daily placebo (n=40), equimolar sodium chloride (n=40), or sodium bicarbonate (n=40) while being maintained on their antihypertensive regimens (including angiotensin-converting enzyme [ACE] inhibition) treated to conventional BP targets. In keeping with their relatively preserved renal function, participants were not acidotic at enrollment with a mean total CO2 in ≥26 mmol/L. After 5 years, the rate of eGFR decline, estimated using plasma cystatin C, was slower and eGFR significantly higher in patients receiving sodium bicarbonate (baseline cysGFR [in ml/min per 1.73 m2], 73.2; after 5 years, 66.4) than in those given placebo (baseline, 73.5; after 5 years, 60.8) or sodium chloride (baseline, 73.5; after 5 years, 62.7). This interesting study calls for use of sodium bicarbonate in patients with early CKD even in the absence of overt acidosis (17).