{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:43:05Z","timestamp":1775666585501,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Nephrology"],"published-print":{"date-parts":[[2023,7,28]]},"abstract":"<jats:p>Background. The effect of correcting metabolic acidosis on protein metabolism in hemodialysis patients is controversial. Objectives. To study the effects of oral sodium bicarbonate on protein metabolism and markers of inflammation in acidotic hemodialysis patients. Patients and Methods. An open-label randomized controlled trial was conducted at a single center. Sixty-six clinically stable adult hemodialysis patients were recruited with an average predialysis serum bicarbonate level of &lt;22\u2009mmol\/l and a dialysate bicarbonate concentration of 35\u2009mmol\/l. Forty-nine participants have completed the study. Oral sodium bicarbonate tablets of 500\u2009mg were given daily in the intervention group (n\u2009=\u200925) for 12\u2009weeks versus the standard of care in the control group (n\u2009=\u200924). Outcomes compared intervention versus nonintervention in both groups at equivalent time points (0 and 3\u2009months). The clinical data, anthropometry, dialysis adequacy, albumin, normalized protein catabolism rate, blood gas analysis, and bicarbonate were recorded at 0 and 3\u2009months. In addition, muscle mass and handgrip strength were measured. Finally, IL-6 as a marker of inflammation was measured at randomization and three months. Results. Serum bicarbonate and pH increased significantly from 17.57\u2009\u00b1\u20093.34\u2009mmol\/L to 20.69\u2009\u00b1\u20092.54\u2009mmol\/L and from 7.26\u2009\u00b1\u20090.06 to 7.34\u2009\u00b1\u20090.04, respectively (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.0001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). Serum albumin was significantly higher in the intervention group at three months than in the control group, 4.11\u2009\u00b1\u20090.45 vs. 3.79\u2009\u00b1\u20090.47 (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                     <\/c:math>\n                  <\/jats:inline-formula> value 0.011). Serum potassium significantly decreased in the intervention group at three months compared to the control group, 5.00\u2009\u00b1\u20090.43\u2009mEq\/l vs. 5.33\u2009\u00b1\u20090.63\u2009mEq\/l (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                     <\/e:math>\n                  <\/jats:inline-formula> value 0.03). Muscle strength expressed as handgrip has improved significantly in the intervention group at three months compared to the control group, 45.01\u2009\u00b1\u200919.19 vs. 33.93\u2009\u00b1\u200915.06 (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                     <\/g:math>\n                  <\/jats:inline-formula> value 0.03). The IL-6 values were less in the intervention group at 3\u2009months with a <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                     <\/i:math>\n                  <\/jats:inline-formula> value of 0.01. The interdialytic weight of the intervention group at three months was 2.42\u2009\u00b1\u20090.64 compared to the 2.20\u2009\u00b1\u20091.14 control group, but this did not reach statistical significance (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>p<\/k:mi>\n                     <\/k:math>\n                  <\/jats:inline-formula> value of 0.4). The composite of (albumin\u2009+\u2009nPCR) at three months was achieved in 59.18% of the intervention group compared to 14.28% with a <jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>p<\/m:mi>\n                     <\/m:math>\n                  <\/jats:inline-formula> value of 0.01. Conclusions. Correcting metabolic acidosis in hemodialysis patients improved serum albumin and nPCR without hypokalemia or significant interdialytic weight gain. This was particularly evident in patients with minimal inflammation with low IL-6 values.<\/jats:p>","DOI":"10.1155\/2023\/6657188","type":"journal-article","created":{"date-parts":[[2023,7,29]],"date-time":"2023-07-29T02:35:11Z","timestamp":1690598111000},"page":"1-9","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Oral Sodium Bicarbonate Supplementation on Protein Metabolism and Inflammation in Iraqi Hemodialysis Patients: An Open-Label Randomized Controlled Trial"],"prefix":"10.1155","volume":"2023","author":[{"given":"Zina A.","family":"Rasheed","sequence":"first","affiliation":[{"name":"Nephrology and Renal Transplantation Centre, Baghdad Medical City, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ban A.","family":"AL-Hashemi","sequence":"additional","affiliation":[{"name":"Baghdad Al-Russafa Health Directorate, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5538-6068","authenticated-orcid":true,"given":"Ala A.","family":"Ali","sequence":"additional","affiliation":[{"name":"Nephrology and Renal Transplantation Centre, Baghdad Medical City, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1159\/000514550"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.08.028"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.5049\/ebp.2014.12.2.80"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/mnh.0000000000000491"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1159\/000508980"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00481.x"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1172\/jci117668"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1172\/jci118566"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1111\/j.0894-0959.2004.17347.x"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-021-00498-0"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2008111205"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1681\/asn.v84632"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1996.196"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.05.006"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.4103\/jrnm.jrnm_9_21"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000456"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.20748"},{"issue":"3","key":"18","first-page":"236","article-title":"Evaluation of nutritional parameters of hemodialysis patients","volume":"16","author":"K. 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