Metabolic acidosis in patients with chronic kidney disease (CKD) is associated with increased risk for death, investigators reported at the Kidney Week 2020 Reimagined virtual conference.

Using de-identified 2007 to 2017 data from the Optum® electronic medical record database, Navdeep Tangri, MD, of the University of Manitoba in Winnipeg, Manitoba, Canada, and colleagues studied 51,558 patients with non-dialysis CKD stages 3 to 5 who had at least 2 serum bicarbonate tests 28 to 365 days apart, 3 or more estimated glomerular filtration rate (eGFR) values less than 60 mL/min/1.73 m2, and at least 2 years of post-index data or who died during that period. Of these, 17,350 patients had metabolic acidosis (serum bicarbonate less than 22 mEq/L) and 34,208 had normal serum bicarbonate levels (22 to 29 mEq/L).

The unadjusted rates of all-cause mortality within 2 years were significantly higher in the metabolic acidosis group than those with normal serum bicarbonate levels (30.9% vs 10.2%; P <.0001), according to the investigators. In addition, each 1 mEq/L decrease in serum bicarbonate level was significantly associated with a 15% higher risk for all-cause mortality, independent of age, race, sex, preexisting comorbidities, and baseline eGFR and albumin-to-creatinine ratio.

Continue Reading

Disclosure: This clinical trial was commercially supported. Please see the original reference for a full list of authors’ disclosures.


Tangri N, Reaven NL, Funk SE, Mathur VS. Metabolic acidosis is a predictive factor for all-cause mortality in patients with CKD. Presented at: Kidney Week 2020 Reimagined virtual conference, October 19 to 25. Poster PO1483.