Kidney Week

Abstract: TH-PO1072

Effect of Sodium Bicarbonate on Blood N-terminal Pro B-type Natriuretic Peptide (NT-proBNP) and Fetuin Levels: A Secondary Analysis of the VA-Bicarb Trial

Session Information

• CKD: Therapeutic Advances
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Gudino, Paola, New York City Health and Hospitals Corporation, New York, New York, United States

Paola Gudino, MD

• Koike, Seiji, Oregon Health & Science University, Portland, Oregon, United States

Seiji Koike, MS

• Lapidus, Jodi A., Oregon Health & Science University, Portland, Oregon, United States

Jodi A. Lapidus, PhD

• Arrieta-Asmadt, Daniela A., University of Utah Health, Salt Lake City, Utah, United States

Daniela A. Arrieta-Asmadt

• Dobre, Mirela A., University Hospitals, Cleveland, Ohio, United States

Mirela A. Dobre, MD, FASN, MPH

• Abramowitz, Matthew K., Albert Einstein College of Medicine, Bronx, New York, United States

Matthew K. Abramowitz, MD, MS, FASN

• Hostetter, Thomas H., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Thomas H. Hostetter, MD

• Cheung, Alfred K., University of Utah Health, Salt Lake City, Utah, United States

Alfred K. Cheung, MD

• Chen, Wei, Albert Einstein College of Medicine, Bronx, New York, United States

Wei Chen, MD, MS, FASN

• Melamed, Michal L., New York University, New York, New York, United States

Michal L. Melamed, MD

• Raphael, Kalani L., University of Utah Health, Salt Lake City, Utah, United States

Kalani L. Raphael, MD, MS, FASN

Background

NaHCO3 is often used to treat metabolic acidosis in chronic kidney disease (CKD). However, NaHCO3 has been hypothesized to cause fluid retention and increase risk of vascular calcification. We conducted a secondary analysis of the VA-Bicarb Trial to determine the effect of NaHCO3 on blood N-terminal pro-b-type natriuretic peptide (NT-proBNP) and fetuin levels.

Methods

NT-proBNP and fetuin were measured from stored samples of participants in the VA-Bicarb Trial, a six-month, double-blind, randomized, placebo-controlled NaHCO3 trial of 74 US Veterans with stage 2-4 CKD attributed to diabetes. Measurements were performed at baseline, month-3, and month-6. Generalized linear mixed effects models were fit and a series of hypothesis tests were performed to globally asses differences in biomarker trajectory between treatment groups as well as intergroup differences at each visit. Additionally, we analyzed intragroup biomarker variations at each visit relative to the group baseline values.

Results

The mean (SD) age was 72 (8) years, 72 (97%) male, and 64 (87%) non-Hispanic White. Mean (SD) eGFR was 56 (20) ml/min/1.73m² and median (IQR) urinary ACR was 121 (58, 370) mg/g. Median (IQR) NT-proBNP was 81 (48, 219) pg/mL and mean (SD) fetuin was 840 (187) μg/mL. Fetuin decreased in both the NaHCO3 and placebo groups at month-3; month-6 values returned to near baseline levels in both groups (Figure 1A). There was no significant change in NT-proBNP levels in either group during follow-up (Figure 1B). Overall, there was no statistically significant difference in NT-proBNP or fetuin between the groups.

Conclusion

Among US Veterans with stage 2-4 CKD attributed to diabetes, treatment with NaHCO3 had no effect on blood NT-proBNP or fetuin levels.

Blood fetuin (A) and NT-proBNP (B) levels during follow-up by treatment group.

Funding

• NIDDK Support