Explorative Study to Investigate the Acid-base Response to Sodium and Potassium Salts in Patients With Chronic Kidney Disease.

Launched by ERASMUS MEDICAL CENTER · Jan 25, 2024

Keywords

ClinConnect Summary

Rationale: Patients with chronic kidney disease (CKD) consume a low potassium diet which is associated with progressive CKD and cardiovascular disease. Increasing dietary potassium intake to recommended levels may therefore improve cardiorenal outcomes, but the response to increased potassium intake in patients with CKD is unclear. Therefore, the investigators recently tested the response to 40 mmol potassium chloride in patients with CKD and showed that this is generally well-tolerated. However, patients did develop mild hyperchloremic metabolic acidosis, which may offset the beneficial ef...

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Eligibility criteria

• Inclusion Criteria:
• • Adult patients (≥ 18 years)
• • CKD G3b or G4 (44 - 15 ml/min/1.73 m2)
• • Use of RAAS-I (ACE-inhibitor or angiotensin receptor blocker, ARB)
• Exclusion Criteria:
• • Use of any of the following drugs or supplements: mineralocorticoid receptor antagonists, potassium-sparing diuretics, oral potassium binders, immunosuppressive medication, tolvaptan, acetazolamide, topiramate, sodium bicarbonate.
• • Patients using double RAAS blockade (i.e., ACE-inhibitor + ARB).
• • Metabolic alkalosis (plasma bicarbonate \>27 mmol/L) at last outpatient visit
• • Kidney transplant recipients
• • Patients with an active gastro-intestinal ulcer
• • Patients with previous history of ventricular cardiac arrhythmia
• • Patients with a life expectancy \< 6 months
• • Incapacitated subjects or subjects who are deemed unfit to adequately adhere to instructions from the research team
• • Women who are pregnant, breastfeeding or consider pregnancy in the coming 7 weeks
• • Patients with chronic respiratory acidosis in previous medical history
• • Hyperkalemia (plasma potassium \>5.5 mmol/L) at V0