Acid-Base Compensation in Chronic Kidney Disease (ABC)
Chronic Kidney Disease
About this trial
This is an interventional prevention trial for Chronic Kidney Disease focused on measuring Kidney Diseases, Renal Insufficiency, Chronic, Dietary nonvolatile acid load, Blood pressure, Urine net acid excretion
Eligibility Criteria
Inclusion Criteria:
- estimated glomerular filtration rate ≥30 ml/min/1.73m2
- serum bicarbonate 20-28 mEq/L
Exclusion Criteria:
- diabetes mellitus
- uncontrolled hypertension or recent (<3 weeks) titration of blood pressure medications
- clinically significant volume overload on screening physical examination
- selected medical conditions other than kidney disease and hypertension (active cancer, chronic liver failure, moderate to severe COPD, New York Heart Association class 2 or greater congestive heart failure, obstructive sleep apnea requiring nightly continuous positive airway pressure, solid organ transplant)
- use of alkali supplementation
- body mass index <18.5 or >40 kg/m2
- ideal body weight <45.5 kg
- anemia at screening (hematocrit <29% in participants with kidney disease or <33% in healthy participants)
- pregnancy or breastfeeding
- allergies, intolerance or unwillingness to consume foods or supplement provided in feeding menu
- serum calcium less than 8.6 mg/dl on screening laboratories
Sites / Locations
- Duke University School of Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Controlled diet first
Sodium bicarbonate first
In this arm participants will first consume a controlled diet plus added table salt (sodium chloride) for one week. They will then consume an identical controlled diet plus sodium bicarbonate for one week. Sodium bicarbonate will be dosed as 2,600 mg divided three times daily if ideal body weight is <70 kg or 3,250 mg divided three times daily if ideal body weight is ≥70 kg. Added table salt will match the sodium content of the sodium bicarbonate dose (i.e. 31 or 39 mEq/day).
In this arm participants will first consume a controlled diet plus sodium bicarbonate for one week. They will then consume an identical controlled diet plus added table salt (sodium chloride) for one week. Sodium bicarbonate will be dosed as 2,600 mg divided three times daily if ideal body weight is <70 kg or 3,250 mg divided three times daily if ideal body weight is ≥70 kg. Added table salt will match the sodium content of the sodium bicarbonate dose (i.e. 31 or 39 mEq/day).