Sodium bicarbonate is an antacid medication that can help treat people with kidney disease who develop metabolic acidosis.
Kidney disease, also known as “chronic kidney disease” (CKD), is a condition in which the kidneys are damaged and unable to filter blood properly. Over time, CKD can lead to a variety of complications, such as high blood pressure and cardiovascular disease.
Another common complication of CKD is metabolic acidosis, which occurs when too much acid builds up in the body. About 15% of people with CKD have metabolic acidosis.
Treatment for metabolic acidosis may include dietary changes, prescription medications, and a compound called “sodium bicarbonate.”
Learn more about kidney disease.
Sodium bicarbonate, more commonly known as “baking soda,” is a medication that helps reduce stomach acid. It belongs to a group of medications called antacids.
Sodium bicarbonate is commonly used as an over-the-counter (OTC) medication to relieve occasional heartburn, indigestion, or upset stomach.
Sodium bicarbonate is also used as a
- metabolic acidosis
- hyperkalemia
- lactic acidosis
- diabetic ketoacidosis
- renal tubular acidosis
Sodium bicarbonate is available as an oral tablet and a powder that can be dissolved in water. It can also be given by intravenous injection or infusion.
In people with CKD who develop metabolic acidosis, the kidneys can’t remove enough acid from the body. A buildup of acid disrupts the typical
Bicarbonate is a base substance that helps the body maintain an average pH balance.
The typical level of bicarbonate in the blood (serum bicarbonate) is 22–29 millimoles per liter (mmol/L). People with metabolic acidosis have persistently low serum bicarbonate levels below 22 mmol/L.
Sodium bicarbonate is a base supplement that can be given as a prescription medication to increase serum bicarbonate levels and help maintain a pH balance.
The goals of treatment with sodium bicarbonate are to:
- increase serum bicarbonate levels back to the average range
- manage and treat metabolic acidosis
- prevent more severe metabolic acidosis and potential complications
- slow the progression of CKD
Only take sodium bicarbonate as directed
If you have CKD, you should only take sodium bicarbonate pills if prescribed by a healthcare team, following a doctor’s instructions. Sodium bicarbonate, when prescribed as a medication, requires careful dosing and monitoring.
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The benefits of treating metabolic acidosis with sodium bicarbonate include:
- preventing more severe metabolic acidosis
- slowing CKD progression
- preventing complications of CKD progression, such as:
- bone loss
- muscle loss
- malnutrition
- insulin resistance
- cardiovascular complications
- improving nutritional status
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Another 2022 study examined the use of sodium bicarbonate treatment in people with late stage CKD and metabolic acidosis. The study found that treatment improved metabolic acidosis and nutritional markers in the blood.
Based on current evidence, the Kidney Disease Improving Global Outcomes Guidelines for CKD suggest sodium bicarbonate is successful at increasing serum bicarbonate levels and preventing more severe acidosis and potential complications.
More research is needed on the effects of sodium bicarbonate treatment for people with CKD.
When ingested, sodium bicarbonate produces carbon dioxide (CO2) gas, which can lead to common gastrointestinal side effects, such as bloating and belching.
Other
- unpleasant taste
- headache
- nausea or vomiting
- increased need to urinate
- nervousness or restlessness
In very rare cases, consuming sodium bicarbonate can cause a rupture of the stomach due to increased intragastric pressure from several factors, including CO2 with food and liquid in the stomach.
For this reason, only take sodium bicarbonate on an empty stomach, and don’t take the total daily dose at one time.
One potential risk of sodium bicarbonate treatment is an increased intake of sodium.
Sodium bicarbonate is a chemical compound that combines sodium (salt) and bicarbonate, so daily treatment with sodium bicarbonate can lead to a substantial increase in sodium intake.
In people with CKD, increased sodium may contribute to:
- weight gain
- fluid retention
- swelling (edema)
- hypertension
High sodium intake also may prevent certain CKD treatments, such as renin-angiotensin-aldosterone system inhibitors, from working as well to slow the progression of kidney disease.
Other potential risks of sodium bicarbonate treatment include exceeding regular serum bicarbonate levels, which can lead to health difficulties, and vascular and kidney calcification.
With careful monitoring from a healthcare professional, sodium bicarbonate treatment is generally
The outlook for people with CKD receiving treatment with sodium bicarbonate depends on the severity and stage of CKD as well as the severity of metabolic acidosis.
Without treatment, metabolic acidosis
Effective treatments for metabolic acidosis include dietary changes, such as eating more alkali-containing fruits and vegetables, and medications such as sodium bicarbonate. These treatments may help improve your outlook if you have kidney disease.
Although more research is needed, sodium bicarbonate has been shown to be effective in managing metabolic acidosis and preventing potential complications.
Why is sodium bicarbonate given for kidney disease?
Sodium bicarbonate is prescribed for people with kidney disease who develop metabolic acidosis, or a buildup of too much acid in the body. The medication can help reduce acid levels in the body, restore pH balance, and potentially slow the progression of CKD.
How can I improve my stage 3 kidney failure?
Although kidney damage isn’t usually reversible in stage 3 CKD, medical treatments and lifestyle changes can help prevent progression to stages 4 or 5. Beneficial lifestyle changes include eating a kidney-friendly diet, getting regular exercise, and quitting smoking or using tobacco if you currently use either.
Sodium bicarbonate is a prescription medication that can help treat people with CKD who develop metabolic acidosis.
As an antacid, sodium bicarbonate helps reduce excess acid levels in the body and keeps serum bicarbonate levels within the average range, which can help prevent more severe metabolic acidosis and potential complications.
People with CKD should only take sodium bicarbonate pills if prescribed by a doctor or healthcare professional. Speak with a doctor to learn if treatment with sodium bicarbonate may be right for you.
