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Daily oral sodium bicarbonate preserves glomerular filtration rate by slowing its decline in early hypertensive nephropathy.
- Source :
-
Kidney international [Kidney Int] 2010 Aug; Vol. 78 (3), pp. 303-9. Date of Electronic Publication: 2010 May 05. - Publication Year :
- 2010
-
Abstract
- 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.
- Subjects :
- Administration, Oral
Adult
Albuminuria drug therapy
Albuminuria physiopathology
Angiotensin-Converting Enzyme Inhibitors pharmacology
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Antihypertensive Agents pharmacology
Antihypertensive Agents therapeutic use
Blood Pressure drug effects
Cystatin C blood
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Hypertension drug therapy
Hypertension physiopathology
Kidney drug effects
Kidney physiopathology
Kidney Diseases physiopathology
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Sodium Bicarbonate administration & dosage
Glomerular Filtration Rate drug effects
Hypertension complications
Kidney Diseases drug therapy
Kidney Diseases etiology
Sodium Bicarbonate pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 1523-1755
- Volume :
- 78
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Kidney international
- Publication Type :
- Academic Journal
- Accession number :
- 20445497
- Full Text :
- https://doi.org/10.1038/ki.2010.129