| Daily oral sodium bicarbonate preserves glomerular filtration rate by slowing its decline in early hypertensive nephropathy. | |
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MedLine Citation:
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PMID: 20445497 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In most patients with hypertensive nephropathy and low glomerular filtration rate (GFR), the kidney function progressively declines despite the adequate control of the hypertension with angiotensin-converting enzyme inhibition. Previously we found that 2 years of oral sodium citrate slowed GFR decline in patients whose estimated GFR (eGFR) was very low (mean 33 ml/min). This treatment also slowed GFR decline in an animal model of surgically reduced nephron mass. Here, we tested if daily oral sodium bicarbonate slowed GFR decline in patients with hypertensive nephropathy with reduced but relatively preserved eGFR (mean 75 ml/min) in a 5-year, prospective, randomized, placebo-controlled, and blinded interventional study. Patients matched for age, ethnicity, albuminuria, and eGFR received daily placebo or equimolar sodium chloride or bicarbonate while maintaining antihypertensive regimens (including angiotensin-converting enzyme inhibition) aiming for their recommended blood pressure targets. After 5 years, the rate of eGFR decline, estimated using plasma cystatin C, was slower and eGFR was higher in patients given sodium bicarbonate than in those given placebo or sodium chloride. Thus, our study shows that in hypertensive nephropathy, daily sodium bicarbonate is an effective kidney protective adjunct to blood pressure control along with angiotensin-converting enzyme inhibition. |
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Authors:
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Ashutosh Mahajan; Jan Simoni; Simon J Sheather; Kristine R Broglio; M H Rajab; Donald E Wesson |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-05-05 |
Journal Detail:
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Title: Kidney international Volume: 78 ISSN: 1523-1755 ISO Abbreviation: Kidney Int. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-15 Completed Date: 2011-01-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: United States |
Other Details:
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Languages: eng Pagination: 303-9 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Texas A&M College of Medicine, Temple, Texas 76508, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Albuminuria / drug therapy, physiopathology Angiotensin-Converting Enzyme Inhibitors / pharmacology, therapeutic use Antihypertensive Agents / pharmacology, therapeutic use Blood Pressure / drug effects Cystatin C / blood Double-Blind Method Drug Therapy, Combination Female Glomerular Filtration Rate / drug effects* Humans Hypertension / complications*, drug therapy, physiopathology Kidney / drug effects, physiopathology Kidney Diseases / drug therapy*, etiology*, physiopathology Longitudinal Studies Male Middle Aged Prospective Studies Sodium Bicarbonate / administration & dosage, pharmacology* |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Cystatin C; 144-55-8/Sodium Bicarbonate |
| Comments/Corrections | |
Comment In:
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Kidney Int. 2010 Oct;78(8):817; author reply 817-8
[PMID:
20877374
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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