PMID- 37476296
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230722
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 7
DP  - 2023 Jul
TI  - Bicarbonate-Based Solution for the Management of Established Acute Kidney Injury: 
      A Pilot Open-Label Observation Study.
PG  - e42127
LID - 10.7759/cureus.42127 [doi]
LID - e42127
AB  - Background Administration of intravenous (IV) solutions constitutes a key 
      component of acute kidney injury (AKI) management. However, the optimal IV fluid 
      solution in the setting of AKI remains uncertain. In this study, we assessed 
      whether the use of bicarbonate-containing solution in patients with established 
      AKI is associated with early renal recovery as compared to bicarbonate-free 
      solutions. Methods We performed an open-label observational pilot study in 59 
      patients with established AKI. IV fluid solutions that were used include 
      bicarbonate-based solution with low chloride content (80 mEq/L of 8% sodium 
      bicarbonate in a solution that contains 77 mEq/L of sodium, 77 mEq/L of chloride 
      and 25 g/L of glucose) or solutions without bicarbonate with high chloride 
      content (0.9% normal saline, 0.45% half-saline, normal ringer, or 4% succinylated 
      gelatine). We evaluated the association of IV fluids type with renal recovery. 
      Results The median age of study participants was 66 years (inter-quartile range 
      (IQR) 37-85), and 59% (n=35) were men. The prevalence of diabetes and chronic 
      kidney disease (CKD) stages 1-3 were 34% (n=20) and 39% (n=23), respectively. 
      Patients who received bicarbonate-based IV solutions had a greater reduction of 
      serum creatinine (sCr) per day (delta sCr) as compared with patients who received 
      bicarbonate-free solutions (-0.29+/-0.47 vs. 0.07+/-0.42; p=0.007). The renal 
      recovery was faster in patients who received bicarbonate-based solutions as 
      compared to the bicarbonate-free group (days from peak sCr to baseline sCr: 
      5.6+/-2.1 vs. 7.6+/-2.8; p < 0.001, respectively). Conclusions We observed faster 
      renal recovery in patients with established AKI who received the 
      bicarbonate-based solution with low chloride content. Our study findings require 
      confirmation in larger cohorts.
CI  - Copyright (c) 2023, Claure-Del Granado et al.
FAU - Claure-Del Granado, Rolando
AU  - Claure-Del Granado R
AD  - Division of Nephrology, Department of Medicine, Hospital Obrero No. 2 - Caja 
      Nacional de Salud (CNS) Universidad Mayor de San Simon, Cochabamba, BOL.
FAU - Prudencio-Ribera, Vania C
AU  - Prudencio-Ribera VC
AD  - Pulmonology, University Hospital of Toledo, Toledo, ESP.
FAU - Gupta, Vineet
AU  - Gupta V
AD  - Medicine/Hospital Medicine, University of California San Diego School of 
      Medicine, San Diego, USA.
FAU - Yang, Jason
AU  - Yang J
AD  - Medicine, University of California San Diego School of Medicine, San Diego, USA.
FAU - Kashani, Kianoush
AU  - Kashani K
AD  - Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, USA.
AD  - Nephrology and Hypertension, Mayo Clinic, Rochester, USA.
FAU - Malhotra, Rakesh
AU  - Malhotra R
AD  - Division of Nephrology and Hypertension, Department of Medicine, University of 
      California San Diego School of Medicine, San Diego, USA.
LA  - eng
PT  - Journal Article
DEP - 20230719
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10355685
OTO - NOTNLM
OT  - acidosis
OT  - acute kidney injury
OT  - bicarbonate-based solutions
OT  - bicarbonate-free solutions
OT  - chloride-rich
OT  - intravenous fluids
OT  - normal saline
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/07/21 06:44
MHDA- 2023/07/21 06:45
PMCR- 2023/07/19
CRDT- 2023/07/21 04:03
PHST- 2023/07/18 00:00 [accepted]
PHST- 2023/07/21 06:45 [medline]
PHST- 2023/07/21 06:44 [pubmed]
PHST- 2023/07/21 04:03 [entrez]
PHST- 2023/07/19 00:00 [pmc-release]
AID - 10.7759/cureus.42127 [doi]
PST - epublish
SO  - Cureus. 2023 Jul 19;15(7):e42127. doi: 10.7759/cureus.42127. eCollection 2023 
      Jul.