The effects of different treatments for metabolic acidosis in non-dialytic chronic kidney disease: A systematic review and meta-analysis
DOI:
https://doi.org/10.12957/demetra.2022.63273Keywords:
Chronic Kidney Disease. Renal insufficiency. Metabolic Acidosis. Glomerular Filtration Rate. Alkalis. Diet. Bicarbonate.Abstract
Objective: The objective of this review was to evaluate which treatments are used to treat metabolic acidosis in Chronic Kidney Disease (CKD) and their effects on disease progression. Methods: A systematic review was carried out, using the PRISMA protocol, of randomized clinical studies in the following databases: Science Direct, Cochrane Library, and National Library of Medicine-PubMed. The inclusion criteria were original articles from randomized clinical trials with dietary intervention with an alkaline fruit and vegetable diet, oral alkali supplementation, or any combination used to treat metabolic acidosis in patients with non-dialysis-dependent CKD. Results: A total of seven studies were included in this review. All studies used some oral alkali as treatment, with sodium bicarbonate being the main alkali administered, and 57% (n=4) used an alkaline diet that was either in line or not with oral alkali. All interventions improved the metabolic acidosis condition. As for the Glomerular Filtration Rate (GFR), a delay in the decline of GFR was found in 57% (n=4) of the studies after improvement in metabolic acidosis. Conclusions: The treatment of metabolic acidosis, when added to dietary interventions, obtained more favorable results on the progression of CKD by improving, in addition to serum bicarbonate, other parameters of interest, such as blood pressure, plasma urea, calcium, phosphatemia, urinary sodium, urinary potassium, urinary albumin, and LDL. Thus, the data support the use of an alkaline diet in treatments to treat metabolic acidosis in patients with CKD.
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