Trial Outcomes & Findings for The BASE Study: Bicarbonate Administration to Stabilize Estimated Glomerular Filtration Rate (eGFR) (NCT NCT02521181)

NCT ID: NCT02521181

Last Updated: 2020-10-20

Results Overview

The prescribed dose for each participant at the end of 28 weeks will be determined by the safety and tolerability of each dose during the intervention period. The primary assessments will examine the percentage of participants in each dose arm who are prescribed (i) the full randomized sodium bicarbonate dose according to the protocol at the end of 28 weeks and (ii) at least 25% of the randomized sodium bicarbonate dose according to the protocol at the end of 28 weeks. The two doses of sodium bicarbonate being tested are 0.5 and 0.8 mEq/kg-lean body weight per day.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

194 participants

Primary outcome timeframe

Baseline, 28 weeks

Results posted on

2020-10-20

Participant Flow

Patients were recruited from the CKD medical clinic patients of the recruiting centers.

Participant milestones

Participant milestones
Measure
Lower Dose Sodium Bicarbonate
Participants will receive oral 0.5 milliequivalents (mEq)/kg-lean body weight (LBW)/day of sodium bicarbonate. Half of the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Lower Dose Sodium Bicarbonate: Lower dose oral Sodium Bicarbonate (0.5 milliequivalents (mEq)/kg-LBW/day)
Higher Dose Sodium Bicarbonate
Participants will receive 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Higher Dose Sodium Bicarbonate: Higher dose oral Sodium Bicarbonate (0.8 mEq/kg-LBW/day)
Placebo
Participants will take the same number of placebo capsules as if they were assigned to receive either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Placebo: Oral placebo equivalent to either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of Sodium Bicarbonate
Overall Study
STARTED
52
90
52
Overall Study
COMPLETED
52
90
52
Overall Study
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The BASE Study: Bicarbonate Administration to Stabilize Estimated Glomerular Filtration Rate (eGFR)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Lower Dose Sodium Bicarbonate
n=52 Participants
Participants will receive oral 0.5 milliequivalents (mEq)/kg-lean body weight (LBW)/day of sodium bicarbonate. Half of the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Lower Dose Sodium Bicarbonate: Lower dose oral Sodium Bicarbonate (0.5 milliequivalents (mEq)/kg-LBW/day)
Higher Dose Sodium Bicarbonate
n=90 Participants
Participants will receive 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Higher Dose Sodium Bicarbonate: Higher dose oral Sodium Bicarbonate (0.8 mEq/kg-LBW/day)
Placebo
n=52 Participants
Participants will take the same number of placebo capsules as if they were assigned to receive either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Placebo: Oral placebo equivalent to either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of Sodium Bicarbonate
Total
n=194 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=157 Participants
Age, Categorical
Between 18 and 65 years
20 Participants
n=99 Participants
39 Participants
n=107 Participants
15 Participants
n=206 Participants
74 Participants
n=157 Participants
Age, Categorical
>=65 years
32 Participants
n=99 Participants
51 Participants
n=107 Participants
37 Participants
n=206 Participants
120 Participants
n=157 Participants
Age, Continuous
65.9 years
STANDARD_DEVIATION 14.0 • n=99 Participants
67.3 years
STANDARD_DEVIATION 10.8 • n=107 Participants
66.2 years
STANDARD_DEVIATION 10.8 • n=206 Participants
66.6 years
STANDARD_DEVIATION 11.7 • n=157 Participants
Sex: Female, Male
Female
21 Participants
n=99 Participants
29 Participants
n=107 Participants
13 Participants
n=206 Participants
63 Participants
n=157 Participants
Sex: Female, Male
Male
31 Participants
n=99 Participants
61 Participants
n=107 Participants
39 Participants
n=206 Participants
131 Participants
n=157 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
6 Participants
n=99 Participants
8 Participants
n=107 Participants
3 Participants
n=206 Participants
17 Participants
n=157 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
46 Participants
n=99 Participants
82 Participants
n=107 Participants
49 Participants
n=206 Participants
177 Participants
n=157 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=157 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
2 Participants
n=107 Participants
1 Participants
n=206 Participants
3 Participants
n=157 Participants
Race (NIH/OMB)
Asian
3 Participants
n=99 Participants
3 Participants
n=107 Participants
2 Participants
n=206 Participants
8 Participants
n=157 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
2 Participants
n=157 Participants
Race (NIH/OMB)
Black or African American
17 Participants
n=99 Participants
27 Participants
n=107 Participants
23 Participants
n=206 Participants
67 Participants
n=157 Participants
Race (NIH/OMB)
White
28 Participants
n=99 Participants
55 Participants
n=107 Participants
26 Participants
n=206 Participants
109 Participants
n=157 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
2 Participants
n=157 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
3 Participants
n=157 Participants
Region of Enrollment
United States
52 participants
n=99 Participants
90 participants
n=107 Participants
52 participants
n=206 Participants
194 participants
n=157 Participants
CKD Stage
Stage 3A (eGFR 45-60)
9 Participants
n=99 Participants
17 Participants
n=107 Participants
4 Participants
n=206 Participants
30 Participants
n=157 Participants
CKD Stage
Stage 3B (eGFR 30-45)
30 Participants
n=99 Participants
46 Participants
n=107 Participants
31 Participants
n=206 Participants
107 Participants
n=157 Participants
CKD Stage
Stage 4 (eGFR 15-30)
13 Participants
n=99 Participants
27 Participants
n=107 Participants
17 Participants
n=206 Participants
57 Participants
n=157 Participants
Diabetes Mellitus
27 Participants
n=99 Participants
53 Participants
n=107 Participants
25 Participants
n=206 Participants
105 Participants
n=157 Participants
History of Heart Disease
18 Participants
n=99 Participants
28 Participants
n=107 Participants
20 Participants
n=206 Participants
66 Participants
n=157 Participants
Congestive Heart Failure
5 Participants
n=99 Participants
8 Participants
n=107 Participants
7 Participants
n=206 Participants
20 Participants
n=157 Participants
COPD
4 Participants
n=99 Participants
6 Participants
n=107 Participants
0 Participants
n=206 Participants
10 Participants
n=157 Participants
Smoking Status
Never
26 Participants
n=99 Participants
47 Participants
n=107 Participants
25 Participants
n=206 Participants
98 Participants
n=157 Participants
Smoking Status
Former Smoker
15 Participants
n=99 Participants
39 Participants
n=107 Participants
25 Participants
n=206 Participants
79 Participants
n=157 Participants
Smoking Status
Current Smoker
11 Participants
n=99 Participants
4 Participants
n=107 Participants
2 Participants
n=206 Participants
17 Participants
n=157 Participants
Weight
96.1 kg
STANDARD_DEVIATION 25.8 • n=99 Participants
95.4 kg
STANDARD_DEVIATION 22.4 • n=107 Participants
93.6 kg
STANDARD_DEVIATION 20.3 • n=206 Participants
95.1 kg
STANDARD_DEVIATION 22.7 • n=157 Participants
BMI
32.8 kg/m^2
STANDARD_DEVIATION 8.43 • n=99 Participants
32.8 kg/m^2
STANDARD_DEVIATION 7.87 • n=107 Participants
31.6 kg/m^2
STANDARD_DEVIATION 5.92 • n=206 Participants
32.5 kg/m^2
STANDARD_DEVIATION 7.54 • n=157 Participants
Lean Body Mass
58.4 kg
STANDARD_DEVIATION 10.7 • n=99 Participants
58.4 kg
STANDARD_DEVIATION 9.84 • n=107 Participants
58.7 kg
STANDARD_DEVIATION 9.44 • n=206 Participants
58.5 kg
STANDARD_DEVIATION 9.91 • n=157 Participants
Systolic BP
127 mm Hg
STANDARD_DEVIATION 13.7 • n=99 Participants
127 mm Hg
STANDARD_DEVIATION 12.3 • n=107 Participants
127 mm Hg
STANDARD_DEVIATION 13.0 • n=206 Participants
127 mm Hg
STANDARD_DEVIATION 12.8 • n=157 Participants
Ace/ARB Use
40 Participants
n=99 Participants
60 Participants
n=107 Participants
35 Participants
n=206 Participants
135 Participants
n=157 Participants
eGFR
36.5 ml/min/1.73m^2
STANDARD_DEVIATION 9.56 • n=99 Participants
36.4 ml/min/1.73m^2
STANDARD_DEVIATION 9.60 • n=107 Participants
34.5 ml/min/1.73m^2
STANDARD_DEVIATION 8.59 • n=206 Participants
35.9 ml/min/1.73m^2
STANDARD_DEVIATION 9.32 • n=157 Participants
Urine Albumin / Creatinine Ratio
222 g/mg
n=99 Participants
176 g/mg
n=107 Participants
147 g/mg
n=206 Participants
181 g/mg
n=157 Participants
Serum Bicarbonate
24.2 meq/L
STANDARD_DEVIATION 2.25 • n=99 Participants
24.2 meq/L
STANDARD_DEVIATION 2.38 • n=107 Participants
23.8 meq/L
STANDARD_DEVIATION 2.17 • n=206 Participants
24.1 meq/L
STANDARD_DEVIATION 2.28 • n=157 Participants
Serum Potassium
4.5 meq/L
STANDARD_DEVIATION 0.4 • n=99 Participants
4.4 meq/L
STANDARD_DEVIATION 0.4 • n=107 Participants
4.5 meq/L
STANDARD_DEVIATION 0.5 • n=206 Participants
4.5 meq/L
STANDARD_DEVIATION 0.4 • n=157 Participants
Urinary Ammonium
19.3 mmol/day
STANDARD_DEVIATION 10.5 • n=99 Participants
22.0 mmol/day
STANDARD_DEVIATION 12.2 • n=107 Participants
20.5 mmol/day
STANDARD_DEVIATION 13.2 • n=206 Participants
20.9 mmol/day
STANDARD_DEVIATION 12.0 • n=157 Participants
Urinary PH
5.86 units on a scale
STANDARD_DEVIATION 0.46 • n=99 Participants
5.75 units on a scale
STANDARD_DEVIATION 0.46 • n=107 Participants
5.81 units on a scale
STANDARD_DEVIATION 0.56 • n=206 Participants
5.80 units on a scale
STANDARD_DEVIATION 0.49 • n=157 Participants
Estimated DIetary Protein Intake
73.3 g/day
STANDARD_DEVIATION 25.4 • n=99 Participants
81.9 g/day
STANDARD_DEVIATION 30.5 • n=107 Participants
79.1 g/day
STANDARD_DEVIATION 29.5 • n=206 Participants
78.8 g/day
STANDARD_DEVIATION 29.0 • n=157 Participants

PRIMARY outcome

Timeframe: Baseline, 28 weeks

The prescribed dose for each participant at the end of 28 weeks will be determined by the safety and tolerability of each dose during the intervention period. The primary assessments will examine the percentage of participants in each dose arm who are prescribed (i) the full randomized sodium bicarbonate dose according to the protocol at the end of 28 weeks and (ii) at least 25% of the randomized sodium bicarbonate dose according to the protocol at the end of 28 weeks. The two doses of sodium bicarbonate being tested are 0.5 and 0.8 mEq/kg-lean body weight per day.

Outcome measures

Outcome measures
Measure
Lower Dose Sodium Bicarbonate
n=52 Participants
Participants will receive oral 0.5 milliequivalents (mEq)/kg-lean body weight (LBW)/day of sodium bicarbonate. Half of the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Lower Dose Sodium Bicarbonate: Lower dose oral Sodium Bicarbonate (0.5 milliequivalents (mEq)/kg-LBW/day)
Higher Dose Sodium Bicarbonate
n=90 Participants
Participants will receive 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Higher Dose Sodium Bicarbonate: Higher dose oral Sodium Bicarbonate (0.8 mEq/kg-LBW/day)
Placebo
n=52 Participants
Participants will take the same number of placebo capsules as if they were assigned to receive either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Placebo: Oral placebo equivalent to either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of Sodium Bicarbonate
Number of Participants in Each Dose Arm Prescribed (i) Full Randomized Sodium Bicarbonate Dose at End of 28 Weeks & (ii) at Least 25% of Randomized Sodium Bicarbonate Dose at End of 28 Weeks as a Proportion of the Number Randomized to That Group
Number of Patients Completing on Full Dose
50 participants
78 participants
45 participants
Number of Participants in Each Dose Arm Prescribed (i) Full Randomized Sodium Bicarbonate Dose at End of 28 Weeks & (ii) at Least 25% of Randomized Sodium Bicarbonate Dose at End of 28 Weeks as a Proportion of the Number Randomized to That Group
Num of Patients Completing on >= 25% of Full Dose
51 participants
82 participants
48 participants

Adverse Events

Lower Dose Sodium Bicarbonate

Serious events: 5 serious events
Other events: 40 other events
Deaths: 0 deaths

Higher Dose Sodium Bicarbonate

Serious events: 16 serious events
Other events: 74 other events
Deaths: 0 deaths

Placebo

Serious events: 7 serious events
Other events: 42 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Lower Dose Sodium Bicarbonate
n=52 participants at risk
Participants will receive oral 0.5 milliequivalents (mEq)/kg-lean body weight (LBW)/day of sodium bicarbonate. Half of the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Lower Dose Sodium Bicarbonate: Lower dose oral Sodium Bicarbonate (0.5 milliequivalents (mEq)/kg-LBW/day)
Higher Dose Sodium Bicarbonate
n=90 participants at risk
Participants will receive 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Higher Dose Sodium Bicarbonate: Higher dose oral Sodium Bicarbonate (0.8 mEq/kg-LBW/day)
Placebo
n=52 participants at risk
Participants will take the same number of placebo capsules as if they were assigned to receive either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Placebo: Oral placebo equivalent to either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of Sodium Bicarbonate
Renal and urinary disorders
Reached ESRD (Dialysis or Transplant)
0.00%
0/52 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
0.00%
0/52 • 32 Weeks
Cardiac disorders
Cardiovascular Hospitalizations
1.9%
1/52 • Number of events 1 • 32 Weeks
3.3%
3/90 • Number of events 3 • 32 Weeks
3.8%
2/52 • Number of events 2 • 32 Weeks
Gastrointestinal disorders
Gastrointestinal Hospitalizations
3.8%
2/52 • Number of events 2 • 32 Weeks
3.3%
3/90 • Number of events 3 • 32 Weeks
0.00%
0/52 • 32 Weeks
Injury, poisoning and procedural complications
Infection Hospitalizations
0.00%
0/52 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
1.9%
1/52 • Number of events 2 • 32 Weeks
Renal and urinary disorders
Renal Hospitalizations
1.9%
1/52 • Number of events 1 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
1.9%
1/52 • Number of events 1 • 32 Weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Malignancy Hospitalizations
0.00%
0/52 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
0.00%
0/52 • 32 Weeks
Injury, poisoning and procedural complications
Injury Hospitalizations
0.00%
0/52 • 32 Weeks
0.00%
0/90 • 32 Weeks
1.9%
1/52 • Number of events 1 • 32 Weeks
Respiratory, thoracic and mediastinal disorders
Respiratory Hospitalizations
0.00%
0/52 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
1.9%
1/52 • Number of events 1 • 32 Weeks
Musculoskeletal and connective tissue disorders
Musculoskeletal Hospitalizations
1.9%
1/52 • Number of events 1 • 32 Weeks
5.6%
5/90 • Number of events 5 • 32 Weeks
0.00%
0/52 • 32 Weeks
Endocrine disorders
Endocrine Disorder Hospitalizations
0.00%
0/52 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
0.00%
0/52 • 32 Weeks
Vascular disorders
Vascular Hospitalizations
0.00%
0/52 • 32 Weeks
1.1%
1/90 • Number of events 1 • 32 Weeks
0.00%
0/52 • 32 Weeks
Psychiatric disorders
Psychiatric Hospitalizations
1.9%
1/52 • Number of events 2 • 32 Weeks
0.00%
0/90 • 32 Weeks
1.9%
1/52 • Number of events 1 • 32 Weeks

Other adverse events

Other adverse events
Measure
Lower Dose Sodium Bicarbonate
n=52 participants at risk
Participants will receive oral 0.5 milliequivalents (mEq)/kg-lean body weight (LBW)/day of sodium bicarbonate. Half of the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Lower Dose Sodium Bicarbonate: Lower dose oral Sodium Bicarbonate (0.5 milliequivalents (mEq)/kg-LBW/day)
Higher Dose Sodium Bicarbonate
n=90 participants at risk
Participants will receive 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Higher Dose Sodium Bicarbonate: Higher dose oral Sodium Bicarbonate (0.8 mEq/kg-LBW/day)
Placebo
n=52 participants at risk
Participants will take the same number of placebo capsules as if they were assigned to receive either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of sodium bicarbonate. Half the total daily dose is taken in the morning and the other half is taken in the evening. (If the number of capsules is an odd number, the greater number of capsules will be taken in the morning.) Placebo: Oral placebo equivalent to either 0.5 mEq/kg-LBW/day or 0.8 mEq/kg-LBW/day of Sodium Bicarbonate
Gastrointestinal disorders
Severe gastrointestinal symptoms
17.3%
9/52 • Number of events 15 • 32 Weeks
17.8%
16/90 • Number of events 28 • 32 Weeks
9.6%
5/52 • Number of events 6 • 32 Weeks
Gastrointestinal disorders
Moderate gastrointestinal symptoms
13.5%
7/52 • Number of events 17 • 32 Weeks
24.4%
22/90 • Number of events 36 • 32 Weeks
25.0%
13/52 • Number of events 17 • 32 Weeks
Gastrointestinal disorders
Mild gastrointestinal symptoms
46.2%
24/52 • Number of events 54 • 32 Weeks
40.0%
36/90 • Number of events 107 • 32 Weeks
46.2%
24/52 • Number of events 62 • 32 Weeks

Additional Information

Jennifer J. Gassman, PhD

Cleveland Clinic Foundation

Phone: (216) 444-9938

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place