ANZIC-RC Renal and Metabolic Program

Renal and metabolic management plays a critical role in the care of critically ill patients. However, these interventions can also lead to complications such as acute kidney injury, metabolic acidosis and metabolic derangements. Therefore, there is an urgent need to advance renal and metabolic strategies to optimise patient outcomes, minimise complications, and improve the quality of care. The Renal and Metabolic Program, led by Associate Professor Ary Serpa Neto, was developed to:

  1. Conduct high-quality, meaningful research that addresses the needs of consumers and generates new knowledge to impact global renal and metabolic practices and outcomes for critically ill patients;
  2. Improve capacity and skill in renal and metabolic research across Australia and New Zealand; and,
  3. Mentor academic clinician researchers of all disciplines with an interest in renal and metabolic care.

The SODa-BIC trial (SODium BICarbonate for Metabolic Acidosis in the Intensive Care Unit: A multicentre, randomised, double-blind clinical trial) is an example of the studies conducted under the Renal and Metabolic Program. Furthermore, the program has generated studies investigating acute kidney injury management and outcomes, renal replacement therapy strategies, and acid-base derangements. These studies represent a comprehensive effort to explore and refine renal and metabolic outcomes, paving the way for improved patient care and outcomes.

The Renal and Metabolic Program Team includes:

The Renal and Metabolic Program Projects include:

Publications

  1. Serpa Neto A, McNamara M, Cooper J, et al. Protocol summary and statistical analysis plan for the sodium bicarbonate for metabolic acidosis in the intensive care unit (SODa-BIC) trial. Crit Care Resusc. 2025 May 15;27(2):100108.
  2. Serpa Neto A, Nasser A, Marella P, et al. Impact of mild hypercapnia in critically ill patients with metabolic acidosis. J Crit Care 2025;85:154936.
  3. Serpa-Neto A, Bellomo R, Wald R, Bagshaw SM. Regional Practice Variation in the Management of Renal Replacement Therapy Modalities in the STARRT-AKI Trial. Blood Purif 2025:1-23.
  4. Maeda A, Brown A, Spano S, et al. Furosemide with adjunctive acetazolamide vs furosemide only in critically ill patients: A pilot two-center randomized controlled trial. J Crit Care 2025;86:155002.
  5. Serpa Neto A, Fujii T, McNamara M, et al. Sodium Bicarbonate for Metabolic Acidosis in the ICU: Results of a Pilot Randomized Double-Blind Clinical Trial. Crit Care Med 2023;51:e221-e233.
  6. Neto AS, Fujii T, Moore J, et al. Clinical outcomes of Indigenous Australians and New Zealand Māori with metabolic acidosis and acidaemia. Crit Care Resusc 2023;24:14-19.
  7. Guy C, Holmes NE, Kishore K, Marhoon N, Serpa-Neto A. Decompensated metabolic acidosis in the emergency department: Epidemiology, sodium bicarbonate therapy, and clinical outcomes. Crit Care Resusc 2023;25:71-77.
  8. Fujii T, Udy AA, Nichol A, Bellomo R, et al. Incidence and management of metabolic acidosis with sodium bicarbonate in the ICU: An international observational study. Crit Care 2021;25:45.
  9. Serpa Neto A, Fujii T, El-Khawas K, Udy A, Bellomo R. Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a survey of Australian and New Zealand intensive care clinicians. Crit Care Resusc 2020;22:275-280.
  10. Naorungroj T, Neto AS, Fujii T, Jude B, Udy A, Bellomo R. Stability of bicarbonate in normal saline: a technical report. Crit Care Resusc 2020;22:83-85.
  11. Jude B, Naorungroj T, Neto AS, Fujii T, Udy A, Bellomo R. Sodium bicarbonate in 5% dextrose: can clinicians tell the difference? Crit Care Resusc 2020;22:80-82.
  12. Serpa Neto A, Naorungroj T, Gallagher M, Bellomo R. Impact of Intensity of Continuous Renal Replacement Therapy on Duration of Ventilation in Critically Ill Patients: A Secondary Analysis of the RENAL Trial. Blood Purif 2023;52:888-897.
  13. White K, Laupland KB, Bellomo R, Serpa-Neto A. The interaction of net ultrafiltration rate with urine output and fluid balance after continuous renal replacement therapy initiation: A multi-Centre study. J Crit Care 2024;83:154835.
  14. White KC, Serpa-Neto A, Hurford R, et al. How a positive fluid balance develops in acute kidney injury: A binational, observational study. J Crit Care 2024;82:154809.
  15. Huang W, Whitelaw J, Kishore K, Neto AS, Holmes NE, Marhoon N, Bellomo R, Ekinci EI. The epidemiology of ketosis and low bicarbonate concentration in inpatients treated with sodium-glucose linked cotransporter inhibitors or dipeptidyl peptidase-4 inhibitors. J Diabetes Complications 2023;37:108522.