Metabolic acidosis is associated with pulse wave velocity in chronic kidney disease: Results from the KNOW-CKD Study

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Biochemistry

Background:

• Metabolic acidosis is a frequent complication in chronic kidney disease (CKD).
• Arterial stiffness is a known predictor of adverse cardiovascular outcomes in CKD patients.
• The relationship between metabolic acidosis and arterial stiffness in CKD requires further investigation.

Purpose of the Study:

• To investigate the association between serum bicarbonate levels and arterial stiffness.
• To evaluate metabolic acidosis as a potential contributor to arterial stiffness in CKD patients.
• Utilizing data from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD).

Main Methods:

• Cross-sectional analysis of 1,659 pre-dialysis CKD patients from the KNOW-CKD cohort.
• Serum bicarbonate levels were measured to define metabolic acidosis (<22 mmol/L).
• Brachial-to-ankle pulse wave velocity (baPWV) was used as a measure of arterial stiffness.

Main Results:

• The mean serum bicarbonate level was 25.8 ± 3.6 mmol/L.
• Metabolic acidosis was present in 12.7% of the study population.
• Patients with metabolic acidosis exhibited significantly higher baPWV (P < 0.001).
• A significant inverse correlation was observed between serum bicarbonate and baPWV (Unstandardized β -5.4 cm/sec; P = 0.017) after adjustment.

Conclusions:

• Metabolic acidosis is significantly associated with increased arterial stiffness (high baPWV) in pre-dialysis CKD patients.
• These findings highlight the importance of managing metabolic acidosis to potentially mitigate cardiovascular risk in CKD.
• Further research is warranted to explore causal relationships and therapeutic interventions.