Sodium bicarbonate (NaHCO 3 ) prescription and extracellular volume increase: real‐world data results from the AlcalUN study
- Type de publi. : Article dans une revue
- Date de publi. : 26/09/2021
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Auteurs :
Julie BeaumeLucile FigueresMickaël BobotLouis de LaforcadeHamza AyariThibault Dolley‐hitzeVictor GueutinAntoine BraconnierLéonard GolbinSalvatore CitardaGuillaume SeretLisa BelaïdRaphaël CohenYosu LuqueFabrice LarceneuxRiyad N.H. SeervaiCamille OversJean‐philippe Bertocchio
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Organismes :
Hopital d'instruction des armées Sainte-Anne [Toulon]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
Hôpital de la Conception [CHU - APHM]
Centre Hopitalier Pierre Oudot [Bourgoin-Jallieu]
Hôpital Européen Georges Pompidou [APHP]
AUB Santé
CHU Pitié-Salpêtrière [AP-HP]
AURA Paris - Plaisance
Hôpital universitaire Robert Debré [Reims]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Centre associatif lyonnais de dialyse
Association ECHO [Expansion des Centres d’Hémodialyse de l’Ouest]
AUB Santé
Hôpital Européen Georges Pompidou [APHP]
CHU Tenon [AP-HP]
CoRaKiD - Maladies rénales fréquentes et rares : des mécanismes moléculaires à la médecine personnalisée
Dauphine Recherches en Management
Baylor College of Medicine
Centre Hospitalier Universitaire [CHU Grenoble]
CHU Pitié-Salpêtrière [AP-HP]
- Publié dans Clinical Pharmacology and Therapeutics le 30/10/2020
Résumé : Oral alkalization with sodium bicarbonate (NaHCO3) or citrate is prescribed for conditions ranging from metabolic acidosis to nephrolithiasis. While most nephrologists/urologists use this method routinely, extracellular volume (ECV) increase is the main feared adverse event reported for NaHCO3. Thus far, no trial has specifically studied this issue in a real-world setting. AlcalUN (NCT03035812) is a multicentric, prospective, open-label cohort study with nationwide (France) enrollment in 18 (public and private) nephrology/urology units. Participants were adult outpatients requiring chronic (>1 month) oral alkalization by either NaHCO3-containing or no-NaHCO3-containing agents. The ECV increase (primary outcome) was judged based on body weight increase (ΔBW), blood pressure increase (ΔBP), and/or new-onset edema at the first follow-up visit (V1). From 02/2017 to 02/2020, 156 patients were enrolled. After a median 106 days of treatment, 91 (72%) patients reached the primary outcome. They had lower systolic (135 [125, 141] vs. 141 [130, 150], p=0.02) and diastolic (77 [67, 85] vs. 85 [73, 90], p=0.03) BP values, a higher plasma chloride (106.0 [105.0, 109.0] vs. 105.0 [102.0, 107.0], p=0.02) at baseline, and a less frequent history of nephrolithiasis (32 vs. 56%, p=0.02). Patients experienced mainly slight increases in blood pressure (ΔBP<10 mmHg). The primary outcome was not associated (p=0.79) with the study treatment (129 received NaHCO3, 27 received citrate). We subsequently developed 3 different models of propensity score matching; each confirmed our results. Chronic oral alkalization with NaHCO3 is no longer associated with an ECV increase compared to citrate in real-life settings.
Fichiers liés :
Clin Pharma and Therapeutics - 2021 - Beaume.pdf
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