Related Experiment Video

Updated: Jun 5, 2025

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

489

Longitudinal serum bicarbonate and mortality risk in older patients with advanced chronic kidney disease: analyses

Gianmarco Lombardi1, Nicholas C Chesnaye2,3, Fergus J Caskey4

  • 1Division of Nephrology, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata, Verona, Italy.

Clinical Kidney Journal
|December 13, 2024
PubMed

Insights

Serum bicarbonate (SBC) levels show a U-shaped relationship with mortality in advanced chronic kidney disease (CKD) patients before kidney replacement therapy (KRT). Low SBC before KRT is linked to higher mortality risk post-KRT initiation.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Clinical Research

Background:

  • Advanced chronic kidney disease (CKD) affects serum bicarbonate (SBC) levels.
  • Understanding SBC's role in mortality is crucial across different CKD stages.

Purpose of the Study:

  • To investigate the association between serum bicarbonate (SBC) and all-cause mortality in advanced chronic kidney disease (CKD).
  • To examine this relationship across three distinct phases: pre-kidney replacement therapy (KRT), transition to KRT, and during KRT.

Main Methods:

  • Utilized the European QUALity Study on treatment in advanced CKD (EQUAL) cohort (n=1485, age ≥65, eGFR ≤20 mL/min/1.73 m²).
  • Employed multivariable time-dependent Cox regression models to analyze longitudinal SBC and mortality.
  • Assessed effect modification by clinical variables and KRT status.

Main Results:

  • A U-shaped relationship between SBC and mortality was observed in the pre-KRT population (P=.03).
  • Low cumulative SBC exposure before KRT initiation was associated with increased mortality risk after starting KRT (P=.01).
  • A trend towards increased mortality risk with low SBC was noted in the KRT population (P=.13).

Conclusions:

  • The association between SBC and mortality in advanced CKD differs across treatment stages.
  • A U-shaped curve characterizes the SBC-mortality link pre-KRT, while low SBC indicates higher risk during KRT.
Abstract

Keywords:
bicarbonatechronic kidney diseaseelderlymortality

More Related Videos

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis04:36

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Published on: October 2, 2020

2.2K
Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes07:22

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Published on: March 7, 2025

197

Related Concept Videos

Diagnosing Acidosis and Alkalosis01:24

Diagnosing Acidosis and Alkalosis

Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2  and...
163
Bicarbonate-Carbonic Acid Buffer01:22

Bicarbonate-Carbonic Acid Buffer

The carbonic acid-bicarbonate buffer system is critical for maintaining the body's pH balance. It operates on the equilibrium:
774
Disorders of Acid-Base Balance01:29

Disorders of Acid-Base Balance

The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
144
Roles of Electrolytes: Chloride and Bicarbonate01:29

Roles of Electrolytes: Chloride and Bicarbonate

Chloride ions contribute to the osmotic pressure gradient distinguishing the intracellular fluid (ICF) from the extracellular fluid (ECF). They counterbalance positively charged ions in the ECF and ensure its electrochemical stability. The renal system's process of chloride absorption and release generally mirrors that of sodium ions.
Conditions such as hypochloremia can arise from insufficient chloride reabsorption by the kidneys, often compounded by extended bouts of diarrhea, vomiting,...
142
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies01:27

Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies

Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
2.5K
Kaplan-Meier Approach01:24

Kaplan-Meier Approach

The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
98