Metabolic acidosis in chronic kidney disease (CKD)
- Confirm persistent low bicarbonate/acid load
- Treat reversible causes first
- Oral sodium bicarbonate is standard alkali
- Correct clinically important acidosis
- Watch BP, edema + sodium burden
- More plant alkali may help selected patients
- Recheck bicarbonate after titration
Use at a glance
- Confirm persistent low bicarbonate/acid load
Practical pearls
- Treat reversible causes first
- Oral sodium bicarbonate is standard alkali
- Correct clinically important acidosis
- Watch BP, edema + sodium burden
Choosing treatment
- More plant alkali may help selected patients
Other practical pearls
- Recheck bicarbonate after titration
Self-check
- What should be treated first in CKD metabolic acidosis?
Reversible causes. - What is the standard alkali for metabolic acidosis in CKD?
Oral sodium bicarbonate.
Drugs used for this (1)
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