Sodium Bicarbonate Supplementation Research Articles

Sodium Bicarbonate Treatment and Clinical Outcomes in Chronic Kidney Disease with Metabolic Acidosis: A Meta-Analysis.

In patients with chronic kidney disease (CKD), impaired kidney acid excretion leads to the onset of metabolic acidosis (MA). However, the evidence is not yet conclusive regarding the effects of sodium bicarbonate in treating CKD with MA. Databases with PubMed, Embase, and the Cochrane Library were used to search for randomized controlled trials from the inception until November 11, 2023 to identify randomized controlled trials investigating the effect of sodium bicarbonate in participants with CKD and MA. The primary outcome was the change in estimated glomerular filtration rate (eGFR). Secondary outcomes included hospitalization rates, change in systolic blood pressure (SBP), all-cause mortality, and mid-arm muscle circumference (MAMC). A random-effects model was applied for analysis, and subgroup, sensitivity analyses were also performed. Fourteen RCTs comprising 2,037 patients demonstrated that sodium bicarbonate supplementation significantly improved eGFR (standardized mean difference [SMD]: 0.33, 95% CI: 0.03 to 0.63, P = 0.03). The group receiving sodium bicarbonate had a lower hospitalization rate (odds ratio: 0.37, 95% CI: 0.25 to 0.55, P < 0.001). Higher MAMC was observed with sodium bicarbonate treatment compared with those without (SMD:0.23, 95% CI: 0.08 to 0.38, P = 0.003, I2 < 0.001). However, higher risk of elevated SBP was found with sodium bicarbonate treatment (SMD:0.10, 95% CI: 0.01 to 0.20, P = 0.03). No significant difference in all-cause mortality was noted. In patients with CKD and MA, sodium bicarbonate supplementation may provide potential benefits in preventing the deterioration of kidney function and increasing muscle mass. However, treatment may be associated with higher blood pressure. Due to the risk of bias stemming from the absence of double-blinded designs and inconsistencies in control group definitions across the studies, further research is crucial to verify these findings.

The effect of oral sodium bicarbonate on the improvement of interdialytic acidosis and hyperkalemia in prevalent hemodialysis patients

Background Uremic toxins closely fit the saw-toothed profile including electrolytes, such as potassium, which is statistically associated with peri-dialytic morbidity and mortality. Acidosis follows a similar inverse pattern, with the bicarbonate levels gradually falling during the inter-dialytic period, before rapid supplementation during dialysis. Observational studies of clinical outcomes support the view that acidosis is harmful, showing that, after adjustment for comorbidity, pre-dialysis bicarbonate levels (HCO3) below 22 mmol/l are associated with excess mortality. The aim of this work is to study the effect of oral sodium bicarbonate supplementation on improvement of interdialytic acidosis, and hyperkalemia in patients on regular hemodialysis (HD). Patients and methods This was a one-arm interventional study that was conducted on a group of 50 adult end-stage renal disease patients on regular HD 3 times weekly at least for 3 months. Results Our study population’s mean ages were 41.8 ± 10.5 years, with male predominance 58%. PH value before and after sodium bicarbonate supplementation was 7.29 ± 0.07 and 7.38 ± 0.05, respectively, with level change 0.09 ± 0.06, which was statistically significant. Bicarbonate levels before and after sodium bicarbonate supplementation were 18.0 ± 1.8 and 23.4 ± 2.1(mmol/l), respectively, with level change 5.4 ± 1.7 (mmol/l), which was statistically significant. Also, potassium level (K) before and after sodium bicarbonate supplementation was 5.4 ± 0.5 and 5.0 ± 0.4 (mmol/l) respectively with level change –0.4 ± 0.3 (mmol/l), which was statistically significant. Regarding interdialytic body weight before and after sodium bicarbonate supplementation was 75.6 ± 6.5 and 75.5 ± 6.7 (kg), respectively, its change was –0.1 ± 0.5 (kg), which was statistically nonsignificant. As regards systolic blood pressure before and after sodium bicarbonate supplementation was 123.8 ± 11.4 and 125.6 ± 14.3 (mmHg), respectively, its change was 1.8 ± 9.4 (mmHg), which was statistically nonsignificant. Diastolic blood pressure before and after sodium bicarbonate supplementation was 76.0 ± 7.6 and 77.0 ± 8.1 (mmHg), respectively, and its change was 1.0 ± 9.5 (mmHg), which was statistically nonsignificant. Conclusion Oral sodium bicarbonate supplementation is effective in correcting interdialytic metabolic acidosis (PH and bicarbonate level) and hyperkalemia in HD patients without causing any significant increase in interdialytic body weight or systolic-diastolic blood pressure.

Acute Compartment Syndrome and Rhabdomyolysis Caused by a Single Electrical Muscle Stimulation in a 46-Year-Old Female Professional Athlete With Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Disorder: A Case Report.

Electrical muscle stimulation (EMS) training has been recognized as an effective modality for improving body composition, enhancing body strength, and facilitating injury recovery. However, individuals who are new to EMS training and those with certain chronic diseases should exercise caution due to the increased risk of rhabdomyolysis. This case report describes the occurrence of rhabdomyolysis and gluteal compartment syndrome following a single session of EMS training in a 46-year-old Caucasian female professional athlete. The patient was successfully managed with intensive intravenous fluid therapy and sodium bicarbonate supplementation, along with close monitoring of electrolytes and renal function. Electrical muscle stimulation training poses an increased risk of severe complications in individuals with chronic diseases and myopathy. Therefore, careful subject selection is required for EMS training in individuals with chronic diseases and myopathy to prevent common side effects. For individuals trying EMS training for the first time, it is recommended to avoid high-frequency EMS exercises.

Sodium bicarbonate improved CrossFit® Benchmark Fran, but not subsequent 500 m rowing performance

ABSTRACT The aim of this study was to evaluate the influence of sodium bicarbonate (SB) supplementation on physical performance, neuromuscular and metabolic responses during CrossFit® exercise. Seventeen Advanced CrossFit®-trained athletes completed the randomized, double-blind, placebo-controlled crossover protocol consisting of four visits, including two familiarization sessions and two experimental trials separated by a 7-day washout period. Participants supplemented 0.3 g/kg body mass (BM) of SB or placebo 120-min prior to performing the CrossFit® benchmark Fran followed by 500 m of rowing. SB improved time to complete Fran compared to PLA (291.2 ± 71.1 vs. 303.3 ± 77.8 s, p = 0.047), but not 500 m rowing (112.1 s ± 7.9 vs. 113.2 s ± 8.9 s, p = 0.26). No substantial side-effects were reported during the trials. This study showed that SB improved CrossFit® benchmark Fran performance, but not subsequent 500-m rowing. These data suggest that SB might be an interesting supplementation strategy for CrossFit® athletes.

The Effects of a Carbohydrate Hydrogel System for the Delivery of Bicarbonate Mini-Tablets on Acid–Base Buffering and Gastrointestinal Symptoms in Resting Well-trained Male Cyclists

BackgroundA new commercially available sodium bicarbonate (SB) supplement claims to limit gastrointestinal (GI) discomfort and increase extracellular buffering capacity. To date, no available data exists to substantiate such claims. Therefore, the aim of this study was to measure blood acid–base balance and GI discomfort responses following the ingestion of SB using the novel “Bicarb System” (M-SB). Twelve well-trained male cyclists completed this randomised crossover designed study. Maximal oxygen consumption was determined in visit one, whilst during visits two and three participants ingested 0.3 g∙kg−1 BM SB using M-SB (Maurten, Sweden) or vegetarian capsules (C-SB) in a randomised order. Finger prick capillary blood samples were measured every 30 min for pH, bicarbonate (HCO3−), and electrolytes (potassium, chloride, calcium, and sodium), for 300 min. Visual analogue scales (VAS) were used to assess GI symptoms using the same time intervals.ResultsPeak HCO3− was 0.95 mmol∙L−1 greater following M-SB (p = 0.023, g = 0.61), with time to peak HCO3− achieved 38.2 min earlier (117 ± 37 vs. 156 ± 36 min; p = 0.026, r = 0.67) and remained elevated for longer (p = 0.043, g = 0.51). No differences were observed for any electrolytes between the conditions. Aggregated GI discomfort was reduced by 79 AU following M-SB (p < 0.001, g = 1.11), with M-SB reducing stomach cramps, bowel urgency, diarrhoea, belching, and stomach-ache compared to C-SB.ConclusionsThis is the first study to report that M-SB can increase buffering capacity and reduce GI discomfort. This presents a major potential benefit for athletes considering SB as an ergogenic supplement as GI discomfort is almost eliminated. Future research should determine if M-SB is performance enhancing.

Sodium bicarbonate and beta-alanine supplementation: Is combining both better than either alone? A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and performance. Four databases (PubMed, SPORTDiscus, Web Of Science and MEDLINE) were searched using relevant terms for studies involving healthy (e.g. no chronic diseases or conditions) male or female adults of any training status (athletes, physically active and non-athletes) and that investigated BA and SB in isolation and combination at any dose on an exercise outcome. Ten studies, totalling 243 individuals, met the criteria with 12 outcomes for each nutritional supplement. No ergogenic effect was detected in this meta-analysis for BA (SMD = 0.18, 95% CI: -0.06; 0.43, p = 0.13, tau2 = 0, tau = 0, I2 = 0.0%) or SB (SMD = 0.17, 95% CI: -0.08; 0.41, p = 0.16, tau2 = 0, tau = 0, I2 = 0.0%) in isolation. However, there was a beneficial effect for the combination of BA and SB (SMD = 0.32, 95% CI: 0.07; 0.57, p = 0.02, tau2 = 0, tau = 0, I2 = 0.0%). Meta-regression identified no differences between supplementing with BA or SB separately (F = 0.58; p = 0.57). Combining BA and SB improved exercise performance, however, there was no benefit in taking these supplements individually.

Impact of supplementation of sodium bicarbonate in the diet of lactating animals suffering from sub-acute rumen acidosis

Impact of supplementation of sodium bicarbonate in the diet of lactating animals suffering from sub-acute rumen acidosis

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

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

EFFECTS OF ORAL SODIUM BICARBONATE SUPPLEMENTATION ON NUTRITIONAL STATUS OF PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS

To determine the oral sodium bicarbonate supplementation effects on nutritional status of patients undergoing maintenance hemodialysis. In a Medicine department at Combined Military Hospital, Peshawar, a case-control study was carried on “14-October 2021 to 14-April 2022”. It enrolled patients of ESRD on MHD with low serum bicarbonate levels. Patients were allocated into two groups: an experimental group receiving oral sodium bicarbonate and a control group receiving standard care. Parameters such as mid-thigh circumference, serum bicarbonate, and serum albumin were assessed at baseline and after 3 months, with statistical analysis performed using an independent sample t-test. The intervention group had a notable elevation in serum bicarbonate levels (20.87±1.58 mmol/l) as compared to the control group (18.73±2.38 mmol/l) (P = 0.0001). Furthermore, it was observed that the intervention group had a noteworthy elevation in serum albumin levels after 3 months (4.40±0.28 g/l), as compared to the control group (3.77±0.30 g/l) (P = 0.0001). Additionally, there was a statistically significant rise in the average mid-thigh circumference among participants in the intervention group during the third month, in comparison to those of the control group (41.20±1.70 vs. 39.74±1.27 cm; P = 0.001). Oral sodium bicarbonate supplementation in patients on maintenance hemodialysis significantly increased serum bicarbonate level, serum albumin level and mid-thigh size.

The effects of oral sodium bicarbonate supplementation on anthropometric measures in patients with chronic kidney disease: A systematic review and meta-analysis of randomized clinical trials.

Metabolic acidosis (MA) may play a key role in the pathogenesis of protein-energy wasting (PEW) in patients with chronic kidney disease (CKD). To present a comprehensive synthesis of the effect of oral sodium bicarbonate (SB) supplementation on anthropometric measures in patients with CKD, a systematic review was undertaken in PubMed/MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar, of relevant articles published prior to September 2022. The summary statistics of effect size, nonstandardized weighted mean difference (WMD), and 95% confidence interval (CI) were used to compare the effects of SB supplementation on anthropometric parameters vs. control group. To detect probable sources of heterogeneity, a series of predefined subgroup analyses were conducted. In total, 17 studies with 21 treatment arms, including 2203 participants (1149 cases, 1054 controls), met our inclusion criteria and were included in the meta-analysis. SB supplementation had no significant effect on body weight (BW), midarm muscle circumference (MAMC), or lean body mass (LBM) in patients with CKD. There was a significant increase in body mass index (BMI) (MD: 0.59 kg/m2, 95% CI: 0.25 to 0.93, p = 0.001) after SB supplementation in the overall analysis. In subgroup analysis, LBM was increased in studies that were ≥ 24-week duration (MD: 1.81 kg, 95% CI: 0.81 to 2.81) and in participants with BMI lower than 27 kg/m2 (MD: 1.81 mg/L, 95% CI: 0.81 to 2.81). SB supplementation may yield increases in BMI in predialysis CKD patients. However, our findings did not support the beneficial effects of SB supplementation on other anthropometric outcomes. There is an evident need for long-term high-quality interventions to confirm these findings.

Enteric-coated Sodium Bicarbonate Supplementation And The Effects On 2000-m Rowing Performance In Female Athletes

Enteric-coated Sodium Bicarbonate Supplementation And The Effects On 2000-m Rowing Performance In Female Athletes

The Effect of Sodium Bicarbonate Supplementation on Serum Alpha Klotho in Chronic Kidney Disease Patients Stage 3b to 4

Abstract Background Growing evidence suggests that the FGF–Klotho endocrine system also has a crucial role in the pathophysiology of ageing-related disorders, including diabetes, cancer, arteriosclerosis and chronic kidney disease. Aim of the Work The present study aimed to ascertain the potential significance of oral sodium bicarbonate supplementation on soluble α-Klotho serum levels in chronic kidney disease (stage 3b:4) according to CKD-EPI formula. Patients and Methods This was an uncontrolled clinical trial conducted on Inward and OPC patients at El-Demerdash Internal Medicine Hospital. The baseline values of plasma α-klotho were measured in 45 patients having CKD with an estimated glomerular filtration rate (eGFR) of (15:44) mL/min/1.73 m2 (according to CKD-EPI formula) with follow up plasma α-klotho after 3 months of taking sodium bicarbonate tabs orally 0.5 g/12 hrs. Results In our study, 14 (Fourteen) patients with Hypertension, 13 (Thirteen) patients Diabetes, 6 (Six) patients Glomerulus's nephritis, 6 (Six) patients Repeated urinary tract infection, 4 (Four) patient Recurrent stones, 4 (Four) patient Polycystic kidney and 2 (Two) patient Systemic lupus. The Klotho (pg/mL) Before ranged from 296.7 to 976.5 with mean 596.30 ± 202.89 and the Klotho (pg/mL) After ranged from 327.4 to 988.6 with mean 696.16 ± 185.32. The Hco3 before ranged from 17.6 to 22.5 with mean 19.74 ± 1.43 and the Hco3 After ranged from 15 to 28.3 with mean 23.63 ± 3.23. The current study showed that there was non statically significant correlation Between Klotho (pg/mL) and SPB, DPB, Pulse, Temperature, Respiratory rate. The present study showed that there was non statically significant correlation Between Klotho (pg/mL) and Platelets, Urea, Creat, U. creatinine, U. albumin, A/C Ratio, E-GFR, Na, K, Ca, Po4. There was Non statically significant correlation Between Klotho (pg/mL) and Hco3 Before, and there was statically significant Positive correlation Between Klotho (pg/mL)After and Hco3 After. Conclusion There was highly significant difference found between before and after sodium bicarbonate supplementation in terms of Klotho and Hco3 in chronic kidney disease patients stage 3b to 4.

Effects of Oral Sodium Bicarbonate Supplementation on Protein Metabolism and Inflammation in Iraqi Hemodialysis Patients: An Open-Label Randomized Controlled Trial.

The effect of correcting metabolic acidosis on protein metabolism in hemodialysis patients is controversial. 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 <22 mmol/l and a dialysate bicarbonate concentration of 35 mmol/l. Forty-nine participants have completed the study. Oral sodium bicarbonate tablets of 500 mg were given daily in the intervention group (n = 25) for 12 weeks versus the standard of care in the control group (n = 24). Outcomes compared intervention versus nonintervention in both groups at equivalent time points (0 and 3 months). The clinical data, anthropometry, dialysis adequacy, albumin, normalized protein catabolism rate, blood gas analysis, and bicarbonate were recorded at 0 and 3 months. In addition, muscle mass and handgrip strength were measured. Finally, IL-6 as a marker of inflammation was measured at randomization and three months. Serum bicarbonate and pH increased significantly from 17.57 ± 3.34 mmol/L to 20.69 ± 2.54 mmol/L and from 7.26 ± 0.06 to 7.34 ± 0.04, respectively (p < 0.0001). Serum albumin was significantly higher in the intervention group at three months than in the control group, 4.11 ± 0.45 vs. 3.79 ± 0.47 (p value 0.011). Serum potassium significantly decreased in the intervention group at three months compared to the control group, 5.00 ± 0.43 mEq/l vs. 5.33 ± 0.63 mEq/l (p 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 ± 19.19 vs. 33.93 ± 15.06 (p value 0.03). The IL-6 values were less in the intervention group at 3 months with a p value of 0.01. The interdialytic weight of the intervention group at three months was 2.42 ± 0.64 compared to the 2.20 ± 1.14 control group, but this did not reach statistical significance (p value of 0.4). The composite of (albumin + nPCR) at three months was achieved in 59.18% of the intervention group compared to 14.28% with a p value of 0.01. 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.

P30-001-23 Effects of Oral Sodium Bicarbonate Supplementation on Protein Metabolism and Inflammation in Iraqi Hemodialysis Patients: An Open-Label Randomized Controlled Trial

P30-001-23 Effects of Oral Sodium Bicarbonate Supplementation on Protein Metabolism and Inflammation in Iraqi Hemodialysis Patients: An Open-Label Randomized Controlled Trial

#5599 FEBUXOSTAT IN COMBINATION WITH ANAKINRA OR PH NEUTRALIZATION IMPROVE THE OUTCOMES IN HYPERURICEMIA-RELATED URIC ACID CRYSTALLURIA IN MICE

Abstract Background and Aims Currently, it is unknown whether CKD patients with hyperuricemia (HU)-related uric acid (UA) crystalluria, also known as chronic UA nephropathy, would benefit from targeting HU, UA crystallization, and/or inflammation to slow down the progressive decline of kidney function. Although large multi-center RCTs with xanthine oxidase inhibitors (XOIs) such as allopurinol and two Mendelian randomization studies have disproven a causal link between HU and CKD progression, one cannot rule out that XOIs may still represent a viable therapeutic approach for patients with HU-related UA crystalluria in order to prevent CKD progression. This issue requires clarification. To address this, we used our well-established CKD mouse model of HU with UA crystalluria and tested numerous therapeutic approaches including XOI and anakinra. Method Alb-creERT2;Glut9lox/lox (male and female) mice were injected with tamoxifen and placed on an acidogenic diet with the purine inosine to induce HU and crystalluria-related CKD. After chronic UA nephropathy was established on day 14, mice were treated either 1) with the XOIs allopurinol or febuxostat, 2) with sodium bicarbonate supplementation to neutralize urinary pH to prevent UA crystallization, or 3) with anakinra to inhibit IL-1β-driven inflammation, or 4) a combination of the aforementioned therapies for 2 weeks. Saline was used as control. On day 0, 14, and 28, GFR (as primary endpoint) as well as serum UA levels and urinary UA crystals (as secondary endpoints) were determined. At the end of the study, we quantified kidney injury, immune cell infiltration, inflammation, and interstitial fibrosis using histological analysis, ELISA, RT-qPCR, and flow cytometry. Results Therapy with XOIs but not with sodium bicarbonate and anakinra reduced serum UA levels in mice with HU and UA crystalluria. Treating mice with febuxostat improved kidney function (increase in GFR) by preventing kidney injury, UA crystalluria, UA crystal granuloma formation, and interstitial fibrosis compared with the control group, while allopurinol worsened the outcomes of chronic UA nephropathy. On the other hand, sodium bicarbonate supplementation had no effects on serum UA levels, kidney inflammation, immune cell infiltration and interstitial fibrosis but improved kidney function due to less urinary UA crystal deposition (neutralization of urine pH) and granuloma formation as compared with saline-treated mice. As expected, anakinra did not slow down the progression of chronic UA nephropathy as noticed by a similar GFR decline compared with the control group. Although, anakinra reduced the number of infiltrating immune cells and the mRNA expression of inflammatory mediators in the kidney as well as the serum IL-1β concentrations, we observed more interstitial fibrosis. In combination, allopurinol with anakinra did not improve the outcomes of chronic UA nephropathy despite the inhibitory effect of anakinra on the inflammatory response because allopurinol triggered tubulointerstitial nephritis and vasodilation. Interestingly, both combination therapies febuxostat with anakinra and febuxostat with sodium bicarbonate were protective by improving kidney function and preventing UA crystal deposition, kidney injury, inflammation, interstitial fibrosis and UA crystal granuloma formation compared with the single therapies. Conclusion Our interventional study is the first pre-clinical study, which reveals that the XOIs allopurinol and febuxostat have differential effects on the outcomes of HU-related UA crystalluria. While allopurinol contributes to the progression of CKD by causing tubulointerstitial nephritis in mice, febuxostat rather seems to be renoprotective similar to urinary pH neutralization with sodium bicarbonate. We identified both combination therapies febuxostat with anakinra or sodium bicarbonate as most beneficial in order to prevent CKD progression in mice. Thus, febuxostat in combination with IL-1β inhibition or prevention of urinary UA crystallization may represent therapeutic approaches for patients with chronic UA nephropathy.

A Review of Bicarbonate Use in Common Clinical Scenarios

BackgroundThe use of sodium bicarbonate to treat metabolic acidosis is intuitive, yet data suggest that not all patients benefit from this therapy. ObjectiveIn this narrative review, we describe the physiology behind commonly encountered nontoxicologic causes of metabolic acidosis, highlight potential harm from the indiscriminate administration of sodium bicarbonate in certain scenarios, and provide evidence-based recommendations to assist emergency physicians in the rational use of sodium bicarbonate. DiscussionSodium bicarbonate can be administered as a hypertonic push, as a resuscitation fluid, or as an infusion. Lactic acidosis and cardiac arrest are two common scenarios where there is limited benefit to routine use of sodium bicarbonate, although certain circumstances, such as patients with concomitant acute kidney injury and lactic acidosis may benefit from sodium bicarbonate. Patients with cardiac arrest secondary to sodium channel blockade or hyperkalemia also benefit from sodium bicarbonate therapy. Recent data suggest that the use of sodium bicarbonate in diabetic ketoacidosis does not confer improved patient outcomes and may cause harm in pediatric patients. Available evidence suggests that alkalinization of urine in rhabdomyolysis does not improve patient-centered outcomes. Finally, patients with a nongap acidosis benefit from sodium bicarbonate supplementation. ConclusionsEmpiric use of sodium bicarbonate in patients with nontoxicologic causes of metabolic acidosis is not warranted and likely does not improve patient-centered outcomes, except in select scenarios. Emergency physicians should reserve use of this medication to conditions with clear benefit to patients.

Sodium Bicarbonate Supplementation Does Not Improve Repeated Sprint Performance in Vegans and

Sodium Bicarbonate Supplementation Does Not Improve Repeated Sprint Performance in Vegans and

The effects of sodium bicarbonate ingestion on swimming interval performance in trained competitive swimmers

The use of sodium bicarbonate (NaHCO3) supplementation to improve repeated high-intensity performance is recommended; however, most swimming performance studies examine time trial efforts rather than repeated swims with interspersed recovery that are more indicative of training sessions. The aim of this study, therefore, was to investigate the effects of 0.3 g.kg−1 BM NaHCO3 supplementation on sprint interval swimming (8 × 50 m) in regionally trained swimmers. Fourteen regionally competitive male swimmers (body mass (BM): 73 ± 8 kg) volunteered for this double-blind, randomised, crossover designed study. Each participant was asked to swim 8 × 50 m (front crawl) at a maximum intensity from a diving block, interspersed with 50 m active recovery swimming. After one familiarisation trial, this was repeated on two separate occasions whereby participants ingested either 0.3 g.kg−1 BM NaHCO3 or 0.05 g.kg−1 BM sodium chloride (placebo) in solution 60 min prior to exercise. Whilst there were no differences in time to complete between sprints 1–4 (p > 0.05), improvements were observed in sprint 5 (p = 0.011; ES = 0.26), 6 (p = 0.014; ES = 0.39), 7 (p = 0.005; ES = 0.60), and 8 (p = 0.004; ES = 0.79). Following NaHCO3 supplementation, pH was greater at 60 min (p < 0.001; ES = 3.09), whilst HCO3− was greater at 60 min (p < 0.001; ES = 3.23) and post-exercise (p = 0.016; ES = 0.53) compared to placebo. These findings suggest NaHCO3 supplementation can improve the latter stages of sprint interval swimming performance, which is likely due to the augmentation of pH and HCO3− prior to exercise and the subsequent increase in buffering capacity during exercise.

Increased Biomass and Polyhydroxybutyrate Production by Synechocystis sp. PCC 6803 Overexpressing RuBisCO Genes.

The overexpression of the RuBisCO (rbc) gene has recently become an achievable strategy for increasing cyanobacterial biomass and overcoming the biocompound production restriction. We successfully constructed two rbc-overexpressing Synechocystis sp. PCC 6803 strains (OX), including a strain overexpressing a large subunit of RuBisCO (OXrbcL) and another strain overexpressing all large, chaperone, and small subunits of RuBisCO (OXrbcLXS), resulting in higher and faster growth than wild type under sodium bicarbonate supplementation. This increased biomass of OX strains significantly contributed to the higher polyhydroxybutyrate (PHB) production induced by nutrient-deprived conditions, in particular nitrogen (N) and phosphorus (P). As a result of higher PHB contents in OX strains occurring at days 7 and 9 of nutrient deprivation, this enhancement was apparently made possible by cells preferentially maintaining their internal lipids while accumulating less glycogen. The OXrbcLXS strain, with the highest level of PHB at about 39 %w/dry cell weight (DCW) during 7 days of BG11-NP treatment, contained a lower glycogen level (31.9 %w/DCW) than wild type control (40 %w/DCW). In contrast, the wild type control strain exposed to N- and NP-stresses tended to retain lipid levels and store more glycogen than PHB. In this model, we, for the first time, implemented a RuBisCO-overexpressing cyanobacterial factory for overproducing PHB, destined for biofuel and biomaterial biotechnology.

Effect of Sodium Bicarbonate on Systolic Blood Pressure in CKD: A Systematic Review and Meta-Analysis.

Individuals with CKD are at a higher risk of cardiovascular morbidity and mortality. Acidosis is positively correlated with CKD progression and elevated systolic BP. Sodium bicarbonate is an efficacious treatment of acidosis, although this may also increase systolic BP. In this systematic review and meta-analysis, we summarize the evidence evaluating systolic BP and antihypertensive medication change (which may indicate systolic BP change) in response to sodium bicarbonate therapy in individuals with CKD. Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Cochrane Central Register of Controlled Trials, and World Health Organization (WHO) trials registry databases were searched for randomized control trials where sodium bicarbonate was compared with placebo/usual care in CKD stage G1-5 non-dialysis-dependent populations. Random effects meta-analyses were used to evaluate changes in systolic BP and BP-modifying drugs after sodium bicarbonate intervention. Fourteen randomized control trials (2110 individuals, median follow-up 27 [interquartile range 97] weeks, mean age 60 [SD 10] years, mean systolic BP 136 [SD 17] mm Hg, mean eGFR 38 [SD 10] ml/min, mean serum bicarbonate 22 [SD 4] mmol/L) were eligible for inclusion. Meta-analysis suggested that sodium bicarbonate did not influence systolic BP in individuals with CKD stage G1-5. Results were consistent when stratifying by dose of sodium bicarbonate or duration of intervention. Similarly, there was no significant increase in the use of antihypertensive medication or diuretics in individuals taking sodium bicarbonate, whereas there was a greater decrease in antihypertensive medication use in individuals taking sodium bicarbonate compared with controls. Our results suggest, with moderate certainty, that sodium bicarbonate supplementation does not adversely affect systolic BP in CKD or negatively influence antihypertensive medication requirements.