2020
DOI: 10.1186/s12916-020-01542-9
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Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial

Abstract: Background: Chronic kidney disease with metabolic acidosis is common in older people, but the effectiveness of oral sodium bicarbonate therapy in this group is unclear. We tested whether oral sodium bicarbonate provides net health benefit for older people with advanced chronic kidney disease and serum bicarbonate concentrations < 22 mmol/L. Methods: Pragmatic multicentre, parallel group, double-blind, placebo-controlled randomised trial. We recruited adults aged ≥ 60 years with estimated glomerular filtration … Show more

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Cited by 58 publications
(44 citation statements)
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“…Previously, the effect of oral alkali has been discussed [3,[11][12][13]. We observed signi cant differences in pH and bicarbonate levels with and without administration of sodium bicarbonate.…”
Section: Discussionmentioning
confidence: 60%
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“…Previously, the effect of oral alkali has been discussed [3,[11][12][13]. We observed signi cant differences in pH and bicarbonate levels with and without administration of sodium bicarbonate.…”
Section: Discussionmentioning
confidence: 60%
“…Oral sodium bicarbonate has been used for decades to counteract metabolic acidosis [3]. Oral sodium bicarbonate may have a residual renal function-preserving effect in peritoneal dialysis patients [16].…”
Section: Introductionmentioning
confidence: 99%
See 1 more Smart Citation
“… 28 , 30 , 31 , 32 Except for 2 trials enrolling patients with eGFR 60 to 90 with albuminuria and patients with eGFR 15 to 89 ml/min, respectively, 33 , 34 all enrolled participants had eGFR values <60 ml/min per 1.73 m 2 . Of these, 8 trials enrolled participants with CKD stages 3 or 4, 18 , 29 , 35 , 36 , 37 , 38 , 39 , 40 , 41 3 trials enrolled participants with CKD stages 4 or 5, 42 , 43 , 44 1 trial enrolled participants with CKD stages 3 to 5, 45 and 1 trial reported an inclusion criterion as serum creatinine <5 mg/dl (442 μmol/l). 46 One trial did not report an inclusion criterion based on serum bicarbonate concentration.…”
Section: Resultsmentioning
confidence: 99%
“…Six trials were placebo-controlled studies. 33 , 34 , 39 , 41 , 44 , 46
Figure 1 PRISMA flow diagram showing selection of studies.
…”
Section: Resultsmentioning
confidence: 99%