Sodium bicarbonate is an antacid medicine that can help individuals with kidney disease who develop metabolic acidosis.
Kidney disease, also recognized as “chronic kidney disease” (CKD), is a syndrome in which the kidneys are injured and cannot filter blood properly. Over time, CKD can chief to various complications, such as high blood pressure and heart disease.
Another common difficulty of CKD is metabolic acidosis, which occurs when excess acid builds up in the body. Approximately 15% of people with CKD suffer from metabolic acidosis.
Treatment for metabolic acidosis may comprise dietary changes, prescription medications, and a multiple called “sodium bicarbonate.”
What is sodium bicarbonate?
Sodium bicarbonate, more usually known as “baking soda,” is a medication that helps reduce stomach acidity. It belongs to a group of medicines called antacids.
Sodium bicarbonate is generally used as an over-the-counter medication to relieve occasional heartburn, indigestion, or stomach pain.
It is also used under medical supervision to treat conditions caused by an accumulation of acid or potassium in the body. These conditions may comprise:
- metabolic acidosis
- hyperkalemia
- lactic acidosis
- diabetic ketoacidosis
- renal tubular acidosis
Sodium bicarbonate is current as oral tablets and as a powder that can be dissolved in water. It can also be administered via injection or intravenous infusion.
What is the goal of giving kidney disease with sodium bicarbonate?
In persons with chronic kidney disease (CKD) who develop metabolic acidosis, the kidneys cannot remove enough acid from the body. The accumulation of acid disrupts the body’s normal acid-base balance (pH). In addition to having abnormally high acid levels, people with metabolic acidosis have abnormally low blood bicarbonate levels.
Bicarbonate is a basic substance that helps the body maintain a proper pH balance.
Normal blood bicarbonate levels (serum bicarbonate) range from 22 to 29 millimoles each liter (mmol/L). People with metabolic acidosis have obstinately low serum bicarbonate levels—below 22 mmol/L.
Sodium bicarbonate is a basic supplement that can be prescribed to increase serum bicarbonate levels and help maintain pH balance.
The goals of sodium bicarbonate treatment are to:
- restore normal serum bicarbonate levels
- control and treat metabolic acidosis
- prevent the onset of metabolic acidosis and possible complications
- slow the progression of CKD
Take sodium bicarbonate only as directed.
If you have chronic kidney disease (CKD), you should only take sodium bicarbonate tablets if prescribed by your medical team and in accordance with your doctor’s instructions. When sodium bicarbonate is prescribed as a medication, it requires careful dosing and monitoring.
What are the benefits of treating kidney disease with sodium bicarbonate?
The benefits of treating metabolic acidosis with sodium bicarbonate include:
- preventing more severe metabolic acidosis
- slowing the progression of CKD
- preventing complications resulting from CKD progression, such as:
- bone loss
- loss of muscle mass
- malnutrition
- insulin resistance
- cardiovascular complications
- improving nutritional status
A 2021 review found that sodium bicarbonate can help slow the weakening in kidney function and significantly improve vascular endothelial purpose (blood flow) in people with CKD.
Another study from 2022 analyzed the use of sodium bicarbonate as a treatment for people with advanced CKD and metabolic acidosis. The study found that the treatment improved metabolic acidosis and blood nutritional markers.
Based on current evidence, the Kidney Disease: Refining Global Consequences (KDIGO) guidelines for chronic kidney disease (CKD) suggest that sodium bicarbonate is effective for increasing serum bicarbonate levels and stopping more severe acidosis and its potential complications.
Further research is needed on the effects of sodium bicarbonate treatment in people with CKD.
Are there side effects to treating kidney disease with sodium bicarbonate?
When ingested, sodium bicarbonate releases carbon dioxide (CO2), which can cause common gastrointestinal side effects such as bloating and belching.
Other side effects may include:
- unpleasant taste
- headache
- nausea or vomiting
- increased need to urinate
- anxiety or restlessness
In rare cases, consuming sodium bicarbonate can cause stomach distension due to increased intragastric pressure, driven by factors such as the presence of CO2 alongside food and liquids in the stomach.
For this reason, take sodium bicarbonate only on an empty stomach and do not ingest the full daily dose all at once.
What are the risks of treating kidney disease with sodium bicarbonate?
A potential risk of sodium bicarbonate treatment is increased sodium intake.
Sodium bicarbonate is a chemical compound that syndicates sodium (salt) and bicarbonate; therefore, daily treatment with sodium bicarbonate can lead to a significant increase in sodium intake.
In individuals with chronic kidney disease (CKD), higher sodium intake can contribute to:
- weight gain
- fluid retention
- swelling (edema)
- high blood pressure (hypertension)
High sodium intake can also interfere with certain CKD treatments, such as renin-angiotensin-aldosterone system inhibitors, which help slow the progression of kidney disease.
Other potential risks of sodium bicarbonate action include exceeding normal serum bicarbonate levels—which can lead to health problems—as well as vascular and renal calcification.
With careful supervision by a healthcare professional, sodium bicarbonate treatment is generally safe and well-tolerated.
What is the outlook for people with kidney disease who take sodium bicarbonate?
The outlook for individuals with chronic kidney disease (CKD) treated with sodium bicarbonate depends on the severity and stage of the disease, as well as the severity of the metabolic acidosis.
Without conduct, metabolic acidosis can lead to serious complications, such as worsening CKD, osteoporosis, loss of muscle mass, and death.
Effective treatments for metabolic acidosis include dietary changes—such as consuming more alkaline fruits and vegetables—and medications like sodium bicarbonate. These treatments can help improve the outlook if you have kidney disease.
Although further research is needed, sodium bicarbonate is effective in managing metabolic acidosis and averting potential complications.
Frequently Asked Questions
Why is sodium bicarbonate administered for kidney disease?
Sodium bicarbonate is prescribed to people with kidney disease who develop metabolic acidosis—an accumulation of excess acid in the body. This medication can help lower acid levels, restore pH balance, and hypothetically slow the progression of chronic kidney disease (CKD).
How can I manage stage 3 kidney disease?
Although kidney damage is usually irreversible at stage 3 CKD, medical treatments and lifestyle fluctuations can help prevent the disease from progressing to stage 4 or 5. Beneficial lifestyle changes include following a kidney-friendly diet, exercising regularly, and quitting smoking.
Takeaway
Sodium bicarbonate is a treatment medication that can help treat people with chronic kidney disease (CKD) who grow metabolic acidosis.
As an antacid, sodium bicarbonate helps decrease excess acid in the body. It maintains serum bicarbonate levels within the normal range, which can help avoid more severe metabolic acidosis and potential complications.
People with CKD must only take sodium bicarbonate tablets if prescribed by a doctor or healthcare professional. Consult your doctor to determine if sodium bicarbonate treatment is right for you.