Conditions: Metabolic Acidosis Chronic Kidney Disease
Keywords: vascular endothelial cells
Allocation: RANDOMIZED | Intervention model: CROSSOVER
Enrollment: 20
Healthy volunteers: no

Brief summary:
Cardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD) and large artery damage is a major factor that contributes to death. Metabolic acidosis is a common complication of CKD resulting from an inability of the diseased kidney to excrete the daily dietary acid load and it is associated with all-cause mortality in patients with CKD. However, the effect of treatment of metabolic acidosis with oral sodium bicarbonate on endothelial dysfunction and arterial stiffness in patients with CKD has not been evaluated. The investigators propose a prospective, randomized, controlled, open-label 14-week crossover pilot study examining the effect of treatment of metabolic acidosis with oral sodium bicarbonate on vascular endothelial function in 20 patients with CKD stage IV with metabolic acidosis.

Detailed description:

Arms:
arm 1: Patients will start with sodium bicarbonate treatment then switch to control (no treatment) arm 2: Patients will start with control (no treatment) then switch to sodium bicarbonate treatment

Interventions: intervention 1: Sodium bicarbonate intervention 2: Control
Intervention descriptions: intervention 1: Subjects will be treated with oral sodium bicarbonate two to three times per day for a goal serum bicarbonate (HCO3-) of ≥ 23 meq/L. intervention 2: subjects will receive no treatment

Protocol document: