Impact of Sodium Bicarbonate Supplementation on Serum Alpha Klotho in Chronic Kidney Disease Patients

Abstract

Background: The course of chronic kidney disease (CKD) is highly connected with the Klotho gene through multiple pathways, including  renal fibrosis, vascular calcification, inflammation, and mineral bone abnormalities.

Objectives: This study aimed to assess the impact of  oral sodium bicarbonate supplementation on blood levels of soluble α-Klotho in patients suffering from chronic renal disease (stage 3b:4)  at Ain Shams Specialized Hospital in Cairo, Egypt, using the CKD-EPI formula.

Patients and Methods: 45 CKD patients were recruited  for this interventional, prospective, open-label clinical trial from the Inpatient and Outpatient Clinics at Ain Shams Specialized Hospital in  Cairo, Egypt.

Results: The cohort study had an average age of 48.13 ± 6.96 years. Serum bicarbonate (HCO3) improved from mean 19.74 ±  1.43 mmol/L pre-study to 23.63 ± 3.23 mmol/L post-study, with a p-value of 0.000. Additionally, eGFR significantly improved with a p- value of 0.000 following the study. Serum alpha Klotho level was 596.30 ± 148.58 pg/mL before the study and 696.16 ± 172.99 pg/mL after  the study, with a statistically significant difference of 0.006. Serum alpha Klotho after the study did not show a statistically significant link  with serum creatinine, eGFR, potassium and phosphorus, or parathyroid. However, serum bicarbonate level and serum Klotho after the  study showed a statistically significant positive correlation.

Conclusion: Serum soluble α klotho level was significantly higher post-study  compared to pre-study after oral sodium bicarbonate supplementation and improved acidosis.