Researchers are warning patients with lower serum bicarbonate levels while suffering from autosomal dominant polycystic kidney disease (ADPKD) are at increased risk of experiencing more kidney problems. Kidneys filter the blood of wastes and toxins, allowing them to be expelled through urine. If the kidneys operate at reduced function or fail completely, the patient has CKD. There is no cure for CKD, except for transplant.
It affects 10% to 13% of the adult population. Those with the condition are at a higher risk of cardiovascular complications and premature death. The study used data from the Developing Interventions to half Progressing of ADPKD. 296 of the patients had ADPKD. Those with the lowest tertile of baseline serum bicarbonate had almost three times the risk of kidney function getting worse.
The mean age of the patients was 48 years old, while the mean serum bicarbonate level was 26.1 mmol/L. 7.4% of the patients had serum bicarbonate levels which would indicate they had metabolic acidosis. Every 1 mmol/L decrease in serum bicarbonate was significantly associated with a 21% increased risk for worsening kidney function.
Additionally, annual decline increased in eGFR by 0.12 mL/min/1.73 m2 per year in fully adjusted models. Researchers found two things which surprised them. One discovery was the association between serum bicarbonate and kidney outcomes, even if serum bicarbonate was largely in the normal range. The other finding was in the amount of urinary ammonium. Early studies showed looking at serum bicarbonate in people with kidney issues led to better predictions in kidney health. They said this may mean acid-base handling may differ in ADPKD then CKD.
According to researchers, this demonstrates that lower serum bicarbonate is associated with renal deterioration over a period of two and a half years. This also means intervention is possible, using inexpensive sodium bicarbonate to slow ADPKD in patients.
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