Metabolic acidosis is undertreated and underdiagnosed: a retrospective cohort study

ABSTRACT Background Guidelines recommend treatment of metabolic acidosis (MA) in patients with chronic kidney disease (CKD), but the diagnosis and treatment rates in real-world settings are unknown. We investigated the frequency of MA treatment and diagnosis in patients with CKD. Methods In this ret...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2023-05, Vol.38 (6), p.1477-1486
Main Authors: Whitlock, Reid H, Ferguson, Thomas W, Komenda, Paul, Rigatto, Claudio, Collister, David, Bohm, Clara, Reaven, Nancy L, Funk, Susan E, Tangri, Navdeep
Format: Article
Language:English
Subjects:
Acidosis - diagnosis
Acidosis - epidemiology
Acidosis - etiology
Bicarbonates
Humans
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - diagnosis
Retrospective Studies
Sodium Bicarbonate
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Summary:ABSTRACT Background Guidelines recommend treatment of metabolic acidosis (MA) in patients with chronic kidney disease (CKD), but the diagnosis and treatment rates in real-world settings are unknown. We investigated the frequency of MA treatment and diagnosis in patients with CKD. Methods In this retrospective cohort study, we examined administrative health data from two US databases [Optum's de-identified Integrated Claims + Clinical Electronic Health Record Database (US EMR cohort; 1 January 2007 to 30 June 2019) and Symphony Health Solutions IDV® (US claims cohort; 1 May 2016 to 30 April 2019)] and population-level databases from Manitoba, Canada (1 April 2006 to 31 March 2018). Patients who met laboratory criteria indicative of CKD and chronic MA were included: two consecutive estimated glomerular filtration results
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfac299