Oral sodium bicarbonate on the nutritional status of patients on chronic dialysis program: A randomized placebo controlled clinical trial
Abstract
Objective: To evaluate the therapeutic effect of oral sodium bicarbonate in improving the nutritional status of patients with chronic renal failure on chronic dialysis therapy (hemodialysis and peritoneal dialysis). Design: Randomized double blind placebo clinical trial. Setting: RTS Renal Units of Popayan, Colombia. Patients and Methods: 162 patients on chronic dialysis (hemodialysis and peritoneal dialysis) were randomized to either placebo or bicarbonate. Patients received oral sodium bicarbonate, 1.0 g three times daily or placebo. Both groups received treatment for a 4-month period. Results: The study groups were comparable at the beginning of the study (study baseline) and no significant differences were observed in any baseline parameters. At 4 months, the levels of albumin and Subjective Global Assessment (SGA) improved with bicarbonate (p = 0.000), the malnutrition inflammation score and the score of malnutrition in dialysis with bicarbonate decreased significantly (p = 0.000). The PCR remained unchanged in both groups (p = 0,306). An increase of 20% or more from baseline serum albumin was observed in 6 (7.41%) patients who received bicarbonate and 1 (1.23%) of those receiving placebo (p = 0.02). At baseline albumin levelsDownloads
References
NKF-DOQI. Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. AJKD. February 2002, vol 39, No 2. Suppl. 1.
Enríquez J, Arteaga H, Benavides J. Frecuencia de Insuficiencia Renal Crónica. Hospital Universitario San José de Popayán. Acta Médica Colombiana, 1996 (21):101.
Enriquez J, Ceballos O, Mosquera M. Causas de insuficiencia renal crónica en pacientes de diálisis crónica. Memorias X Congreso Colombiano de Nefrología e Hipertensión, Medellín: Sociedad Colombiana de Nefrología, 1997: 14-15.
Bastidas M, Enriquez J, Mosquera M, Ceballos O, Bastidas B, et al. Survival on Chronic Diálisis: CAPD and Hemodiálisis, 10 year experience of a single colombian center. Peritoneal Dialysis International. February
vol. 25, suppl. 1: S23.
Brenner and Rector. The Kidney. 9th edition. Saunders, Philadelphia, 2012: 1215-1275
Szeto CC, Kai-Ming Ch, Chung K, Leung CB, Li P. The beneficial effect of Oral sodium bicarbonate in peritoneal dialysis patients – How long does it last after stopping treatment? Hong Kong J Nephrol. 2005
april; 7(1):14-21.
Szeto CC, Wong TY, Chow KM, Leung CB, Li PK. Oral sodium bicarbonate for the treatment of metabolic acidosis in peritoneal dialysis patients: a randomized placebo-control trial. J Am Soc Nephrol. 2003 Aug;14(8):2119-26.
Movilli E, Viola BF, Camerini C, Mazzola G, Cancarini GC. Correction of metabolic acidosis on serum albumin and protein catabolism in hemodiálisis patients. J Ren Nutr. 2009 Mar;19(2):172-7.
Movilli E, Zani R, Carli O, Sangalli L, Paola A, Camerini C, Cancarini GC, Scolari F, Feller P, Maiorca R. Correction of metabolic acidosis increases serum albumin concentration and decreases kinetically evaluated
protein intake in haemodialysis patients: a prospective study. Nephrol Dial Transplant. 1998 Jul; 13(7):1719-22.
Bosola M, Giungi S, Luciani G. Long term oral sodium bicarbonate supplementation does not improve serum album levels in hemodialysis patients. Nephron Clin Pract. 2007; 106(1):c51-6.
Brito-Ashurst I, Varagunam M, RafteryM, Yaqoob M. Bicarbonate supplementation slows progression of CKD and improves nutritional status. J Am Soc Nephrol. 2009; 20: 2075-2084.
Roderick P, Willis NS, Blakeley S, Jones C, Tomson C. Correction of chronic metabolic acidosis for chronic kidney disease patients. Cochrane Database Syst Rev. 2007 Jan 24; (1):CD001890.
.png)
