Definitions for the levels of evidence (I–IV) can be found at the end of the "Major Recommendations" field.
Guidelines
There are no human trials with clinically relevant outcomes that have assessed the impact of acidosis correction on renal failure progression.
Suggestions for Clinical Care
(Suggestions are based on Level III and IV sources)
There are no studies of the effect of alkali therapy on the progression of renal failure in humans. No recommendations can therefore be made regarding the use of alkali treatment specifically for the purposes of renoprotection.
Definitions:
Levels of Evidence
Level I: Evidence obtained from a systematic review of all relevant randomized controlled trials (RCTs)
Level II: Evidence obtained from at least one properly designed RCT
Level III: Evidence obtained from well-designed pseudo-randomized controlled trials (alternate allocation or some other method); comparative studies with concurrent controls and allocation not randomized, cohort studies, case-control studies, interrupted time series with a control group; comparative studies with historical control, two or more single arm studies, interrupted time series without a parallel control group
Level IV: Evidence obtained from case series, either post-test or pretest/post-test