{"id":"https://openalex.org/W4416870524","doi":"https://doi.org/10.1681/asn.2025rjsprcdh","title":"Muscle Injury with Acid Accumulation but Without Metabolic Acidosis in G3 CKD and Its Response to Dietary Acid Reduction: A Five-Year Randomized Trial","display_name":"Muscle Injury with Acid Accumulation but Without Metabolic Acidosis in G3 CKD and Its Response to Dietary Acid Reduction: A Five-Year Randomized Trial","publication_year":2025,"publication_date":"2025-10-01","ids":{"openalex":"https://openalex.org/W4416870524","doi":"https://doi.org/10.1681/asn.2025rjsprcdh"},"language":"en","primary_location":{"id":"doi:10.1681/asn.2025rjsprcdh","doi":"https://doi.org/10.1681/asn.2025rjsprcdh","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025rjsprcdh","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5112327253","display_name":"Nimrit Goraya","orcid":"https://orcid.org/0000-0003-1429-5711","observed_orcids":["https://orcid.org/0000-0003-1429-5711"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Nimrit Goraya","raw_affiliation_strings":["Baylor Scott and White Central Texas, Temple, Texas, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Baylor Scott and White Central Texas, Temple, Texas, United States;","institution_ids":[]}]},{"author_position":"middle","author":{"id":null,"display_name":"Jan Simoni","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210088475","display_name":"Texas Tech University System","ror":"https://ror.org/0082ybm03","country_code":"US","type":"education","lineage":["https://openalex.org/I4210088475"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jan Simoni","raw_affiliation_strings":["Texas Tech University System, Lubbock, Texas, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Texas Tech University System, Lubbock, Texas, United States;","institution_ids":["https://openalex.org/I4210088475"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076501342","display_name":"Nazan S. Aksan","orcid":"https://orcid.org/0000-0003-4997-4386","observed_orcids":["https://orcid.org/0000-0003-4997-4386"]},"institutions":[{"id":"https://openalex.org/I86519309","display_name":"The University of Texas at Austin","ror":"https://ror.org/00hj54h04","country_code":"US","type":"education","lineage":["https://openalex.org/I86519309"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Nazan Aksan","raw_affiliation_strings":["The University of Texas at Austin Dell Medical School, Austin, Texas, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The University of Texas at Austin Dell Medical School, Austin, Texas, United States","institution_ids":["https://openalex.org/I86519309"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007662129","display_name":"Maninder K. Kahlon","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I86519309","display_name":"The University of Texas at Austin","ror":"https://ror.org/00hj54h04","country_code":"US","type":"education","lineage":["https://openalex.org/I86519309"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Maninder Kahlon","raw_affiliation_strings":["The University of Texas at Austin Dell Medical School, Austin, Texas, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The University of Texas at Austin Dell Medical School, Austin, Texas, United States","institution_ids":["https://openalex.org/I86519309"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5019935894","display_name":"Donald E. Wesson","orcid":"https://orcid.org/0009-0007-7952-7401","observed_orcids":["https://orcid.org/0009-0007-7952-7401"]},"institutions":[{"id":"https://openalex.org/I86519309","display_name":"The University of Texas at Austin","ror":"https://ror.org/00hj54h04","country_code":"US","type":"education","lineage":["https://openalex.org/I86519309"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Donald E. Wesson","raw_affiliation_strings":["The University of Texas at Austin Dell Medical School, Austin, Texas, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The University of Texas at Austin Dell Medical School, Austin, Texas, United States","institution_ids":["https://openalex.org/I86519309"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.41662108,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"10S","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12840","display_name":"Renal function and acid-base balance","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12840","display_name":"Renal function and acid-base balance","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10606","display_name":"Kidney Stones and Urolithiasis Treatments","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10408","display_name":"Chronic Kidney Disease and Diabetes","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/chronic-kidney-disease-stage-3","display_name":"chronic kidney disease stage 3","score":0.9049999713897705},{"id":"https://openalex.org/keywords/metabolic-acidosis","display_name":"metabolic acidosis","score":0.902999997138977},{"id":"https://openalex.org/keywords/acid-accumulation","display_name":"acid accumulation","score":0.8539999723434448},{"id":"https://openalex.org/keywords/muscle-injury","display_name":"muscle damage","score":0.8730000257492065},{"id":"https://openalex.org/keywords/sodium-bicarbonate","display_name":"sodium bicarbonate","score":0.8859999775886536},{"id":"https://openalex.org/keywords/physical-functioning","display_name":"physical function","score":0.5329999923706055},{"id":"https://openalex.org/keywords/estimated-glomerular-filtration-rate-decline","display_name":"estimated glomerular filtration rate decline","score":0.6880000233650208},{"id":"https://openalex.org/keywords/dietary-acid-load","display_name":"dietary acid load","score":0.45399999618530273},{"id":"https://openalex.org/keywords/alkali-therapy","display_name":"alkali therapy","score":0.5},{"id":"https://openalex.org/keywords/sarcopenia","display_name":"sarcopenia","score":0.5680000185966492},{"id":"https://openalex.org/keywords/frailty","display_name":"frailty","score":0.36899998784065247},{"id":"https://openalex.org/keywords/hospitalization","display_name":"hospitalization","score":0.4180000126361847},{"id":"https://openalex.org/keywords/quality-of-life","display_name":"quality of life","score":0.43700000643730164}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8141000270843506},{"id":"https://openalex.org/C2779246250","wikidata":"https://www.wikidata.org/wiki/Q1598200","display_name":"Metabolic acidosis","level":2,"score":0.7131999731063843},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.6869000196456909},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6298999786376953},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.4846000075340271},{"id":"https://openalex.org/C2778553927","wikidata":"https://www.wikidata.org/wiki/Q185089","display_name":"Acidosis","level":2,"score":0.4797999858856201},{"id":"https://openalex.org/C3019971869","wikidata":"https://www.wikidata.org/wiki/Q1048687","display_name":"Muscle protein","level":3,"score":0.44699999690055847},{"id":"https://openalex.org/C2779959927","wikidata":"https://www.wikidata.org/wiki/Q1048687","display_name":"Skeletal muscle","level":2,"score":0.3837999999523163},{"id":"https://openalex.org/C2780472472","wikidata":"https://www.wikidata.org/wiki/Q424337","display_name":"Acute kidney injury","level":2,"score":0.31929999589920044},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.29010000824928284}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.2025rjsprcdh","doi":"https://doi.org/10.1681/asn.2025rjsprcdh","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.2025rjsprcdh","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Clinical Trial","id":"https://openalex.org/study-designs/clinical-trial"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4404197663","https://openalex.org/W4415475866","https://openalex.org/W4397041198","https://openalex.org/W4386878767","https://openalex.org/W2949470266","https://openalex.org/W2014046186","https://openalex.org/W2131658070","https://openalex.org/W4403830492","https://openalex.org/W2137195990","https://openalex.org/W7095537524"],"abstract_inverted_index":{"Background:":[0],"Correction":[1],"of":[2,80,209],"metabolic":[3,308],"acidosis":[4,309],"(plasma":[5],"total":[6],"CO2":[7],"[PTCO2]":[8],"<22":[9],"mM)":[10],"in":[11,86,118,218,226,233,241,245,267,310,345],"study":[12,87],"participants":[13,35,88,122,311],"with":[14,36,44,89,123,312,332,353],"G3-G4":[15],"chronic":[16],"kidney":[17],"disease":[18],"(CKD)":[19],"improved":[20],"subjectively":[21],"and":[22,39,62,75,110,113,134,193,220,255,282,328,350],"objectively":[23],"assessed":[24,318],"physical":[25],"function":[26],"(Lancet":[27],"394:396,":[28],"2019).":[29],"We":[30],"tested":[31],"the":[32,156],"hypothesis":[33],"that":[34,301,341],"G3":[37,90,121,180,210,242,277,313],"CKD":[38,314,346],"PTCO2":[40,112,215],">22":[41],"mM":[42],"but":[43,223,264,289],"acid":[45,64,73,143,183,302,330,343],"accumulation":[46,74,184,303,344],"(AJN":[47],"53:794,":[48],"2022),":[49],"for":[50,66,280],"whom":[51],"current":[52],"guidelines":[53],"do":[54],"not":[55,291,304],"recommend":[56],"alkali":[57],"treatment,":[58],"have":[59],"muscle":[60,81,316,348],"injury":[61,317,349],"dietary":[63,140,329],"reduction":[65,331],"five":[67],"years":[68],"reduces":[69],"it.":[70,337],"Methods:":[71],"Body":[72],"serum":[76,114,194,239,278,320],"myosin,":[77,321],"a":[78],"biomarker":[79],"injury,":[82],"were":[83,116,170,204,284,290],"measured":[84,117],"cross-sectionally":[85],"[mean":[91],"(SD)":[92],"eGFR":[93,126,230,326],"39.9":[94],"(6.7)":[95],"ml/min/1.73":[96,105,128],"m2,":[97,106],"n=84]":[98],"compared":[99],"to":[100,131,138,154,161,172,306],"G1":[101,182],"[eGFR":[102],"99.2":[103],"(7.3)":[104],"n=62]":[107],"CKD.":[108],"Baseline":[109],"five-year":[111,212],"myosin":[115,195,240,279],"108":[119],"separate":[120],"mean":[124],"baseline":[125,214,238],"~39":[127],"m2":[129],"randomized":[130],"base-producing":[132,158],"fruits":[133],"vegetables":[135],"(F&V,":[136],"n=36)":[137,150],"reduce":[139],"potential":[141],"renal":[142],"load":[144],"by":[145,319],"half,":[146],"oral":[147],"NaHCO3":[148,333],"(HCO3,":[149],"0.3":[151],"mmol/kg":[152],"bw/day":[153],"approximate":[155],"F&V":[157,219,246,281,335],"potential,":[159],"or":[160,334],"Usual":[162],"Care":[163],"(UC,":[164],"n=36).":[165],"Linear":[166],"mixed":[167],"effect":[168],"regressions":[169],"conducted":[171],"address":[173],"these":[174],"questions.":[175],"Results:":[176],"In":[177,206],"cross-sectional":[178],"studies,":[179],"vs.":[181,187,199,213,237,249,259,271],"[25.6":[185],"(9.0)":[186],"3.8":[188],"(12.5)":[189],"mmoles,":[190],"respectively,":[191,202,253],"p<0.05)]":[192],"[1.35":[196],"(0.01)":[197],"ng/ml":[198],"1.09":[200],"(0.01),":[201],"p<0.01]":[203],"higher.":[205],"longitudinal":[207],"studies":[208],"participants,":[211],"was":[216,224,243,265],"higher":[217,266,285],"HCO3":[221,256,283],"(p<0.05)":[222,228,232],"lower":[225,244],"UC":[227,268,287],"as":[229,325],"declined":[231],"all":[234],"groups.":[235],"Five-year":[236,276],"[1.37":[247],"(0.02)":[248,251,258,261,270,273],"1.40":[250,260],"ng/ml,":[252,262,274],"p<0.001]":[254,263],"[1.38":[257],"[1.46":[269],"1.41":[272],"p<0.001].":[275],"than":[286],"(p<0.002)":[288],"different":[292],"from":[293],"each":[294],"other":[295],"(p=0.94).":[296],"Conclusion:":[297],"The":[298,338],"data":[299,339],"support":[300,340],"sufficient":[305],"cause":[307],"caused":[315],"it":[322],"increased":[323],"further":[324],"declined,":[327],"reduced":[336],"subclinical":[342],"causes":[347],"warrants":[351],"treatment":[352],"alkali.":[354]},"counts_by_year":[],"updated_date":"2026-09-29T14:09:16.559479","created_date":"2025-12-01T00:00:00"}
