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Introduction <p>In response to metabolic acidosis, compensatory mechanisms are deployed by the kidney to maintain acid–base homeostasis. During physical work in the heat, kidney perfusion is reduced, and the metabolic cost of acid–base balance can make the kidneys more prone to acute kidney injury (AKI). Sodium bicarbonate ingestion (NaHCO<sub>3</sub>) may reduce metabolic acidosis and the risk of developing AKI.</p> Purpose <p>We tested the hypothesis that acute NaHCO<sub>3</sub> supplementation reduces the increase in AKI markers during physical work in the heat.</p> Methods <p>In a randomized double-blinded placebo-controlled crossover design 8 participants&#xa0;(3 females) completed 2&#xa0;h of walking at 65% of maximal heart rate in 40&#xa0;°C and ~ 20% relative humidity (RH) with NaHCO<sub>3</sub> (0.2&#xa0;g/kg) or a placebo. Urine samples collected pre- and 1&#xa0;h post-physical work were assayed for insulin-like growth factor binding protein 7 (IGFBP7), tissue inhibitor of metalloproteinase 2 (TIMP-2), and neutrophil gelatinase-associated lipocalin (NGAL).</p> Results <p>The increase in IGFBP7 × TIMP-2 was lower with NaHCO<sub>3</sub> (Δ log 2.77 ± 1.40 [pg/min]<sup>2</sup>) compared to placebo (Δ log 4.19 ± 1.77 [pg/min]<sup>2</sup>) (interaction: p = 0.05). NGAL increased from pre to 1&#xa0;h post in the placebo (Δ log 2.55 ± 0.99&#xa0;pg/min) and NaHCO<sub>3</sub> (Δ log 1.94 ± 1.06&#xa0;pg/min) trials (main effect of time: p &lt; 0.001), but there was no main effect of condition (p = 0.19) or interaction (p = 0.08).</p> Conclusion <p>These findings suggest that acute NaHCO<sub>3</sub> supplementation may be a beneficial intervention for individuals attempting to mitigate AKI risk during physical work in the heat.</p>

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Acute sodium bicarbonate supplementation reduces the increase in markers of acute kidney injury during physical work in the heat

  • 期刊论文

  • 发表日期：

    2025年6月21日

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  • Abdulaziz A. Masoud,
  • Zidong Li,
  • Michael R. Deyhle,
  • Jason Siegler,
  • Jonathan Specht,
  • Zachary J. McKenna,
  • Christine Mermier,
  • Fabiano Amorim

摘要

Introduction

In response to metabolic acidosis, compensatory mechanisms are deployed by the kidney to maintain acid–base homeostasis. During physical work in the heat, kidney perfusion is reduced, and the metabolic cost of acid–base balance can make the kidneys more prone to acute kidney injury (AKI). Sodium bicarbonate ingestion (NaHCO3) may reduce metabolic acidosis and the risk of developing AKI.

Purpose

We tested the hypothesis that acute NaHCO3 supplementation reduces the increase in AKI markers during physical work in the heat.

Methods

In a randomized double-blinded placebo-controlled crossover design 8 participants (3 females) completed 2 h of walking at 65% of maximal heart rate in 40 °C and ~ 20% relative humidity (RH) with NaHCO3 (0.2 g/kg) or a placebo. Urine samples collected pre- and 1 h post-physical work were assayed for insulin-like growth factor binding protein 7 (IGFBP7), tissue inhibitor of metalloproteinase 2 (TIMP-2), and neutrophil gelatinase-associated lipocalin (NGAL).

Results

The increase in IGFBP7 × TIMP-2 was lower with NaHCO3 (Δ log 2.77 ± 1.40 [pg/min]2) compared to placebo (Δ log 4.19 ± 1.77 [pg/min]2) (interaction: p = 0.05). NGAL increased from pre to 1 h post in the placebo (Δ log 2.55 ± 0.99 pg/min) and NaHCO3 (Δ log 1.94 ± 1.06 pg/min) trials (main effect of time: p < 0.001), but there was no main effect of condition (p = 0.19) or interaction (p = 0.08).

Conclusion

These findings suggest that acute NaHCO3 supplementation may be a beneficial intervention for individuals attempting to mitigate AKI risk during physical work in the heat.