{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:29:43Z","timestamp":1790026183556,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,9,27]],"date-time":"2014-09-27T00:00:00Z","timestamp":1411776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["CX000537"],"award-info":[{"award-number":["CX000537"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The prevalence of metabolic acidosis increases as glomerular filtration rate falls. However, most patients with stage 4 chronic kidney disease have normal serum bicarbonate concentration while some with stage 3 chronic kidney disease have low serum bicarbonate, suggesting that other factors contribute to generation of acidosis. The purpose of this study is to identify risk factors, other than reduced glomerular filtration rate, for reduced serum bicarbonate in chronic kidney disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a cross\u2010sectional analysis of baseline data from the Chronic Renal Insufficiency Cohort Study. Multivariable logistic and linear regression models were used to relate predictor variables to the odds of low serum bicarbonate (&lt;22\u2009mM) compared with normal serum bicarbonate (22\u201330\u2009mM) and the coefficients of \u0394 serum bicarbonate concentration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of low serum bicarbonate at baseline was 17.3%. Lower estimated glomerular filtration rate had the strongest relationship with low serum bicarbonate. Factors associated with higher odds of low serum bicarbonate, independent of estimated glomerular filtration rate, were urinary albumin\/creatinine \u226510\u2009mg\/g, smoking, anaemia, hyperkalaemia, non\u2010diuretic use and higher serum albumin. These and younger age, higher waist circumference, and use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers associated with negative \u0394 serum bicarbonate in linear regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Several factors not typically considered to associate with reduced serum bicarbonate in chronic kidney disease were identified including albuminuria \u226510\u2009mg\/g, anaemia, smoking, higher serum albumin, higher waist circumference, and use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers. Future studies should explore the longitudinal effect of these factors on serum bicarbonate concentration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.12315","type":"journal-article","created":{"date-parts":[[2014,7,28]],"date-time":"2014-07-28T03:56:58Z","timestamp":1406519818000},"page":"648-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Prevalence of and risk factors for reduced serum bicarbonate in chronic kidney disease"],"prefix":"10.1111","volume":"19","author":[{"given":"Kalani L","family":"Raphael","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City UT USA"},{"name":"Salt Lake City VA Health Care System  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Ying","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.01.017"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn633"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03730411"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.388"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs609"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2009.02.014"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-14-4"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008020159"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00060505"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.07.013"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000070149.78399.CE"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00070109"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-6-199903160-00002"},{"key":"e_1_2_6_15_1","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification","volume":"39","author":"National Kidney Foundation","year":"2002","journal-title":"Am. 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