Effects of dietary interventions focused on adding base in the management of metabolic acidosis in adults with chronic kidney disease: A protocol for systematic review and meta-analysis of randomized clinical trials
Bibliographic record
Abstract
Abstract Background Metabolic acidosis is a common complication of chronic kidney disease (CKD) which can impair the function of multiple organs and accelerate CKD progression to kidney failure. The condition is usually treated with sodium bicarbonate (NaHCO3), which is an alkali salt. Although effective, alkali therapy has numerous side effects including gastric discomfort and bloating, with many people having difficulty tolerating higher doses. Research has shown that base producing fruit and vegetables may have the ability to increase serum bicarbonate concentrations similar to what is achieved with alkali therapy, but also provides added benefits. This systematic review aims to identify, critically-appraise and meta-analyze findings from randomized clinical trials (RCTs) comparing the effects of dietary interventions, including base producing fruit and vegetables, on serum bicarbonate concentrations as well as other factors related to kidney function in adult patients with CKD. Methods RCTs (in adult participants (18 years of age or older), with CKD will be included in the study. Studies will be excluded if participants are undergoing dialysis or have chronic obstructive pulmonary disease (COPD) requiring oxygen therapy. The interventions of interest are any dietary intervention aimed at manipulating dietary acid load, compared with usual care, no treatment or placebo. Our primary outcome measure will be changes in serum bicarbonate concentration, while other parameters related to kidney function will be considered as secondary outcomes. A knowledge synthesis librarian developed a literature search strategy for MEDLINE (Ovid). The search strategy was then adjusted for use in Cochrane Central (Ovid), Embase (Ovid), Web of Science Core Collection (Clarivate) and CINAHL (EBSCO). Two independent reviewers will select studies for eligibility in Covidence and data extraction will be conducted using a custom MS Excel worksheet. We are planning to perform meta-analysis wherever possible using random effects model. Standardized mean difference (95% confidence interval) and risk ratio will be used to present continuous and dichotomous data, respectively. The assessment of publication bias will be performed using funnel plots and Egger’s regression test while I 2 statistics will be used to assess heterogeneity. We are planning to perform subgroup analysis to deal with potential heterogeneity. Discussion The results of this systematic review and meta-analysis will be useful in designing effective dietary strategies for the management of CKD-related metabolic acidosis. Systematic review registration The present systematic review is registered in International Prospective Register of Systematic Reviews (PROSPERO) ( https://www.crd.york.ac.uk/ , registration ID: CRD42022342612).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.010 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".