CKD Progression Predicted by Serum Biomarker
Low serum bicarbonate (HCO3) levels are associated with chronic kidney disease (CKD) progression, according to a new study.
For their study, the researchers assessed 2378 patients with CKD stages 3 to 5 from a single center in Toronto, Ontario. Mean eGFR was 36 ml/min/1.73m2, and 437 (18%) patients had metabolic acidosis (HCO3 12 to 22).
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The group made use of a kidney failure risk equation (KFRE), developed in 2011, which incorporates age, sex, estimated GFR, albuminuria, serum calcium, serum phosphate, serum bicarbonate, and serum albumin into the prediction of CKD progression.
The primary outcome was defined as a composite of kidney failure or a 40% decline in eGFR. In addition, the researchers assessed the effectiveness of the KFRE in determining the independent effect of correction of metabolic acidosis on CKD progression.
Findings from the study, which were presented at the National Kidney Foundation’s Spring Clinical Meeting 2018, showed that a 1 mEq decline in HCO3 was associated with a 7% increase in kidney failure and/or a 40% decline in eGFR, with rates of both events being consistently 2-times higher than rates of kidney failure alone.
Importantly, the researchers found that “the KFREs were useful in determining the independent effect of serum bicarbonate on CKD progression, and in estimating event rates of validated kidney outcomes.”
“Our findings support increased use of the KFREs in clinical trial design,” the researchers concluded.
—Christina Vogt
Reference:
Tangri N, Ferguson T, Parsell D, Klaener G, Naimark D. Use of the kidney failure risk equations to model clinical trial outcomes. Paper presented at: National Kidney Foundation Spring Clinical Meeting 2018; April 10-14, 2018; Austin, TX. https://www.nkf2018scm.site/Abstracts/NKFSCM18/Gallery - !/b5d84d0e-6602-4763-8955-acbb1622fc70/abstract/263ee647-0773-495c-8a34-55257ec2d94c/viewer
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