Low Serum Bicarbonate May Accelerate Kidney Disease Progression.

Low serum bicarbonate levels increased the risk of kidney disease progression, particularly for individuals with preserved kidney function, in an AJKD study of 3939 patients with CKD stages 2 to 4 who were followed for an average of 3.9 years. The risk of developing ESRD or a 50% reduction in kidney function was 3% lower per 1-mEq/L increase in serum bicarbonate level. Risk was higher for participants with eGFR above 45 mL/min/1.73 m². The risk of heart failure increased by 14% per 1-mEq/L increase in serum bicarbonate level over 24 mEq/L.