Raphael KL, Greene T, Wei G, et al. - By performing this randomized, double-blinded, placebo-controlled study, researchers determined how sodium bicarbonate can influence kidney fibrosis as well as injury markers in people with diabetic kidney disease and normal serum total CO₂. Participants were 74 US veterans, suffering from type 1 or 2 diabetes mellitus. The study sample had eGFR of 15–89 ml/min per 1.73 m², urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g, and serum total CO₂ of 22–28 meq/L. For 6 months, oral sodium bicarbonate (0.5 meq/kg lean body wt per day; n = 35) or placebo (n = 39) was given to the participants. Alteration in urinary TGF-β1-to-creatinine, from baseline to months 3 and 6, was evaluated as the primary outcome. Findings revealed no significant decrease in urinary TGF-β1, kidney injury molecule-1, fibronectin, neutrophil gelatinase-associated lipocalin, or UACR was brought about by sodium bicarbonate over 6 months when administered to patients with nonacidotic diabetic kidney disease.