Effect of Alkali Therapy on Vascular and Graft Function in Kidney Transplant Recipients

Inclusion Criteria

• •Age 18-80 years
• •Serum bicarbonate 16-24 mEq/L on 2 separate measurements (at least 1 day apart)
• •Kidney transplant received 1 year prior to randomization
• •eGFR ≥ 45 ml/min/1.73m2 by CKD-EPI equation
• •Blood pressure \<130/80 mm Hg prior to randomization
• •BMI \< 40 kg/m2 (FMD measurements can be inaccurate in severely obese patients).
• •Able to provide consent
• •Immunosuppression regimen consisting of tacrolimus, mycophenolate mofetil and prednisone (95% of patients at University of Colorado are on this regimen)
• •Stable immunosuppression regimen for at least three months prior to randomization
• •Stable anti-hypertensive regimen for at least one month prior to randomization
• •Not taking medications that interact with agents administered during experimental sessions (e.g. sildenafil interacts with nitroglycerin).