Original InvestigationPathogenesis and Treatment of Kidney DiseaseSerum Bicarbonate Concentrations and Kidney Disease Progression in Community-Living Elders: The Health, Aging, and Body Composition (Health ABC) Study
Section snippets
Study Population
The Health ABC cohort enrolled 3,075 well-functioning men and women aged 70-79 years from 2 clinical sites in Memphis, TN, and Pittsburgh, PA, from April 1997 through June 1998. Participant eligibility required self-reported ability to walk a quarter mile, climb 10 steps, perform basic activities of daily living without difficulty, the absence of life-threatening illness, and plans to remain in the geographic area for at least 3 years. Participants underwent a baseline evaluation that included
Results
By necessity, we excluded individuals who presented to the baseline examination but ultimately did not have sufficient data for analysis due to death or missing follow-up kidney function data. Compared to those with available data, those without were older, were more frequently black, were more likely to be current smokers, had higher ACRs, had more diabetes and obstructive lung disease, and had higher systolic blood pressures. Other variables including baseline eGFR were similar (Table S1,
Discussion
Among well-functioning community-living elders predominantly with preserved kidney function at baseline, we found that lower serum bicarbonate concentrations were associated with more rapid loss of kidney function over time. Within the subset of persons with eGFRs > 60 mL/min/1.73 m2 at baseline, lower serum bicarbonate concentrations were associated with the development of incident eGFRs < 60 mL/min/1.73 m2 during follow-up. These associations became apparent in individuals with serum bicarbonate
Acknowledgements
The Health ABC Study Principal Investigators and Coordinators are as follows: Anne B. Newman, MD, MPH, Piera Kost, Diane Ives, University of Pittsburgh, PA; Suzanne Satterfield, MD, DrPH, Frances A. Tylavsky, DrPH, Jan Elam, University of Tennessee, Memphis; Stephen B. Kritchevsky, PhD, Wake Forest University, Winston-Salem, NC; Steven R. Cummings, MD, Michael C. Nevitt, PhD, Susan M. Rubin, MPH, University of California, San Francisco; and Tamara B. Harris, MD, Melissa E. Garcia, MPH, National
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Cited by (55)
Kidney dysfunction is a significant risk factor for 30-day postoperative complications following shoulder arthroplasty
2022, Seminars in Arthroplasty JSESCitation Excerpt :For example, cardiovascular pathologies contribute to the decline of patients’ GFR due to high vascularity of the kidneys.4 Other factors that potentially lead to low GFR include low serum bicarbonate, obesity, autoimmunity, genetics, and environmental factors.10,12,18,19,55 Measures to prevent the worsening of CKD should also be considered by surgeons before SA.
Acid-Mediated Kidney Injury Across the Spectrum of Metabolic Acidosis
2022, Advances in Chronic Kidney DiseaseAssociation of Serum Uromodulin With ESKD and Kidney Function Decline in the Elderly: The Cardiovascular Health Study
2019, American Journal of Kidney DiseasesCitation Excerpt :A prior study has demonstrated that higher sUMOD levels are associated with lower IF/TA levels,12 suggesting that sUMOD level might be a noninvasive biomarker for IF/TA. Second, sUMOD level may identify individuals with reduced capacity to defend against tubular function insults such as acute kidney injury43 and ischemia44 or maintain homeostasis in systems related to tubular function such as acid-base balance, which in turn are risk factors for ESKD and kidney function decline.45-47 This is supported by research showing that UMOD knockout mice develop more severe acute kidney injury after ischemia-reperfusion injury than wild-type animals.43,48
Acid Base Balance and Progression of Kidney Disease
2019, Seminars in NephrologyCitation Excerpt :Non-CKD cohorts showed similar findings. Among community living elders from the Health, Aging and Body Composition study, those with bicarbonate concentrations less than 23 mEq/L had a faster GFR decline by 0.55 mL/min/1.73 m2 per year (95% CI, 0.13-0.97) compared with those with a bicarbonate concentration of 23 to 28 mEq/L.50 Among participants with an eGFR greater than 60 mL/min/1.73 m2 from the Multiethnic Study of Atherosclerosis, the odds ratio for the association of bicarbonate less than 21 mEq/L compared with those with 23 to 24 mEq/L was 1.35 (95% CI, 1.05-1.73) for rapid kidney function decline, which was defined as more than 5% eGFR decline per year.51 In most epidemiologic studies,46,50,52,53 bicarbonate concentrations were used to assess acid-base status.
Metabolic Acidosis 1 Year Following Kidney Transplantation and Subsequent Cardiovascular Events and Mortality: An Observational Cohort Study
2019, American Journal of Kidney DiseasesSuccessful correction of metabolic acidosis is difficult to achieve inchronic kidney disease
2020, NefrologiaCitation Excerpt :With more sensitive biochemical analysis, such as urinary excretion of ammonium1,2,4 or citrate,5 it can be shown that this metabolic defect begins in earlier stages of CKD and even before a reduction serum bicarbonate is documented. The negative effects of MA on CKD have been the subject of numerous studies showing its association with abnormalities in bone,6,7 metabolic and inflammatory disorders,8,9 endocrine alteration,10–12 progression of CKD13–18 and mortality.19–21 Interestingly, correction of MA improves or reverses many of these abnormalities22–27 which support the recommendation of an active treatment of MA.
Because the Editor-in-Chief and Deputy Editor recused themselves from consideration of this manuscript, the peer-review and decision-making processes were handled entirely by a Co-Editor (James S. Kaufman, MD) who served as Acting Editor-in-Chief. Details of the journal’s procedures for potential editor conflicts are given in the Information for Authors & Editorial Policies.
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A list of the Health ABC Study principal investigators and coordinators appears in the Acknowledgements.