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Current status of bicarbonate in CKD
Mirela Dobre1, Mahboob Rahman1, Thomas H Hostetter2
1Division of Nephrology and Hypertension, Case Western Reserve University, University Hospital Case Medical Center, Cleveland, Ohio.
Treating metabolic acidosis in chronic kidney disease (CKD) with alkali supplementation may offer broad benefits. Correcting low serum bicarbonate levels shows potential for slowing kidney disease progression and improving metabolic and musculoskeletal issues.
Area of Science:
- Nephrology
- Biochemistry
- Internal Medicine
Background:
- Metabolic acidosis is a recognized complication in chronic kidney disease (CKD).
- Despite known negative effects, acidosis treatment in CKD is understudied regarding clinical outcomes.
- Fundamental research and small trials suggest alkali supplementation has potential benefits.
Purpose of the Study:
- To review evidence linking serum bicarbonate levels to clinical outcomes in CKD.
- To discuss the role of alkali supplementation in managing CKD complications.
Main Methods:
- Literature review of published evidence.
- Analysis of studies on serum bicarbonate and clinical outcomes.
- Examination of alkali supplementation trials in CKD patients.
Main Results:
- Accumulated evidence suggests deleterious effects of acidosis in CKD.
- Correcting metabolic acidosis via alkali supplementation shows a broad range of potential benefits.
- Alkali supplementation may retard kidney disease progression.
Conclusions:
- Alkali supplementation is a promising therapeutic strategy for CKD patients with metabolic acidosis.
- Correcting acidosis can improve metabolic and musculoskeletal complications associated with CKD.
- Further research is warranted to confirm benefits on standard clinical outcomes.
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