AUTHOR=Gaggl Martina , Repitz Alexandra , Riesenhuber Sonja , Aigner Christof , Sliber Christopher , Fraunschiel Melanie , Cejka Daniel , Sunder-Plassmann Gere 

TITLE=Effect of Oral Sodium Bicarbonate Treatment on 24-Hour Ambulatory Blood Pressure Measurements in Patients With Chronic Kidney Disease and Metabolic Acidosis

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.711034

DOI=10.3389/fmed.2021.711034

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> Sodium bicarbonate supplementation is a mainstay in the treatment of metabolic acidosis in patients with chronic kidney disease (CKD). Recent studies showed reduction of progression of CKD and reduced all-cause mortality. However, additional sodium loading could worsen arterial hypertension, a well-known contributor to progression of CKD. This patient-relevant and economically negative side effect is under-studied in prospective studies up until now.</p><p><bold>Objective:</bold> The aim of this study was to analyze the effect of sodium bicarbonate treatment on arterial blood pressure at baseline and after 8 weeks.</p><p><bold>Methods:</bold> The SoBic study is an ongoing randomized controlled trial, in which patients with CKD receive either a high dose of oral sodium bicarbonate or a rescue treatment, if necessary. We used standardized office blood pressure and 24-hour ambulatory blood pressure monitoring (24h-ABPM). Regression models were adjusted for estimated glomerular filtration rate and change of antihypertensives.</p><p><bold>Results:</bold> 47 subjects were enrolled and the mean age was 57 (±14.6) years and 18 (38%) were female. In 43 randomized subjects with sufficiently performed 24h-ABPM neither systolic 24h-ABPM (2.522; 95%CI: −2.364, 7.408; mmHg) nor diastolic 24h-ABPM (0.868; 95%CI: −2.411, 4.147; mmHg) was affected by study group allocation. When looking at the effect of individual sodium bicarbonate dose on 24h-ABPM, the fully adjusted model suggested an increase of 0.047 (95%CI: −0.026, 0.119) mmHg by each mg/kg <italic>per</italic> day increase of sodium bicarbonate dose.</p><p><bold>Conclusion:</bold> Sodium bicarbonate supplementation over 8 weeks did not significantly increase blood pressure measured by 24h-ABPM in CKD patients.</p><p><bold>Trial Registration:</bold> EUDRACT Number: 2012-001824-36; 12/07/2012 (<ext-link ext-link-type="uri" xlink:href="https://www.clinicaltrialsregister.eu" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.clinicaltrialsregister.eu</ext-link>).</p>