Safety and efficacy of sodium bicarbonate for treating metabolic acidosis in chronic kidney disease: A systematic review and meta-analysis

Table 1 Study characteristics

Ref.	Study design	Study sample	Intervention/control name		Sample size		Follow-up duration	Dosage of sodium bicarbonate
			Intervention	Control	Intervention	Control	Months
Mathur et al[28]	RCT	Mild to moderate CKD with serum creatinine < 5 mg/dL	Sodium bicarbonate	Placebo	20	20	3	1.2 mEq/kg
Ashurst et al[27]	RCT	Creatinine clearance 15 to 30 ml/min per 1.73 m2 and serum bicarbonate 16 to 20 mmol/L	Sodium bicarbonate	Standard care	67	67	24	600 mg
Goraya et al[26]	RCT	eGFR, 15-29 ml/min per 1.73 m2 and PTCO2 level < 22 mm	Sodium bicarbonate	Fruits and vegetables	35	36	12	1.0 mEq/kg
Abramowitz et al[35]	Clinical trial	eGFR 15-45 ml/min per 1.73 m2 and serum bicarbonate 20-24 mEq/L	Sodium bicarbonate	Placebo	20	20	3	1.0 mEq/kg
Goraya et al[25]	RCT	eGFR 30-59 ml/min and metabolic acidosis characterized by plasma TCO2 > 22 but < 24 mmol/L	Sodium bicarbonate	Standard care	36	36	36	0.3 mEq/kg
Jeong et al[36]	Clinical trial	eGFR < 15-30 mL/min per 1.73 m2 and CO2 less than 22 mEq/L	Sodium bicarbonate	Standard care	40	40	12	1000 mg
Bellasi et al[29]	RCT	CKD-3b-4 with DM2 and serum bicarbonate levels below 24 mEql/L	Sodium bicarbonate	Standard care	71	74	12	0.5 mmol/kg
Yan et al[30]	RCT	eGFR of 15-60 ml/min/1.73 m2, serum HCO3- level of 16-20 mmol/L	Sodium bicarbonate	Placebo	42	42	4.25	N/A
Kendrick et al[31]	RCT	eGFR 15-44 ml/min per 1.73 m2 with low serum bicarbonate levels (16-21 mEq/L)	Sodium bicarbonate	Control group	10	10	6	650 mg
Di Iorio et al[22]	RCT	CKD stage 3-5, serum bicarbonate > 18 and < 24 mmol/L	Sodium bicarbonate	Standard care	376	364	36	N/A
Aigner et al[24]	RCT	CKD stage 3-4 with serum HCO3- ≤ 21 mmol/L	Sodium bicarbonate	Rescue group	18	17	1	840 mg
Goraya et al[23]	RCT	eGFR 30-59 mL/min/1.73 m2 and plasma total CO2 > 22 mM but < 24 mM	Sodium bicarbonate	Standard care	36	36	60	0.3 mEq/kg
Raphael et al[17]	RCT	eGFR 20-44 or 45-59 ml/min per 1.73 m2 and serum bicarbonate 20-28 meq/L	Sodium bicarbonate	Placebo	HD: 90; LD: 90	52	2.25	0.8 mEq/kg
Kittiskulnam et al[28]	RCT	eGFR 15-59 mL/min/1.73 m2, serum bicarbonate level < 22 mEq/L	Sodium bicarbonate	LD sodium bicarbonate	21	21	4	300 mg
Melamed et al[19]	RCT	eGFR of 15-59 ml/min/1.73m2, and serum bicarbonate levels 20 to 26 mEq/L	Sodium bicarbonate	Placebo	74	75	24	0.4 mEq/kg
Dubey et al[33]	RCT	CKD stages 3 and 4 and serum bicarbonate levels < 22 mEq/dL	Sodium bicarbonate	Standard care	94	94	6	0.5 mEq/kg
Witham et al[20]	RCT	CKD stages 3 and 4, and serum bicarbonate levels < 22 mEq/dL	Sodium bicarbonate	Placebo	152	148	24	500 mg
Alva et al[21]	RCT	eGFR of 15-30 mL/min/1.73 m2 and serum bicarbonate 10-20 mm/L	Sodium bicarbonate	Standard care	33	34	9	600 mg
Gaggl et al[34]	RCT	eGFR between 60 and 15 mL/min per 1.73 m2 and a serum HCO3- of ≤ 21 mmol/L	Sodium bicarbonate	Rescue group	24	23	2	N/A
Bovée et al[16]	RCT	eGFR 15-30 ml/min/1.73m2 and plasma bicarbonate levels between 15.0 and 24.0 mmol/L	Sodium bicarbonate	Sodium chloride	15	15	1	1000 mg
Mohebbi et al[32]	RCT	eGFR between 15 mL/min per 1.73 m² and 89 mL/min per 1.73 m² and serum bicarbonate of 22 mmol/L or less	Sodium bicarbonate	Placebo	119	121	24	500 mg
Sorohan et al[15]	RCT	eGFR between 45 and 15 mL/min/1.73 m2 and serum bicarbonate between 10 and 22 mmol/L	Sodium bicarbonate	Sodium citrate	62	62	12	600 mg

RCT: Randomized controlled trial; eGFR: Estimated glomerular filtration rate; CKD: Chronic kidney disease; HD: High dose; LD: Low dose; N/A: Not applicable.