Sodium Bicarbonate Therapy In Patients With Ckd Stages 3 And 4
More than 16 million individuals in the United States are affected by chronic kidney disease . CKD is associated with numerous comorbidities as well as an increased risk for mortality. There are limited treatments known to slow or stop progression of CKD.
Metabolic acidosis is a known complication of kidney disease; it is unclear whether metabolic acidosis causes further kidney damage.; Results of previous observational studies have suggested an association between lower levels of bicarbonate; and faster progression of kidney disease. Further, poor outcomes have been seen in patients with acid retention, even in the absence of overt metabolic acidosis. Results of several small randomized studies cited benefits of alkali therapy in progression of CKD.
Bone and muscles may also be affected in patients with CKD and chronic metabolic acidosis; muscle dysfunction and bone disease may be associated with metabolic acidosis in patients with CKD. Michal L. Melamed, MD, MHS, and colleagues recently conducted a multicenter, randomized, placebo-controlled clinical trial designed to examine whether treatment with sodium bicarbonate improves muscle and bone outcomes. Results of the trial were reported in the American Journal of Kidney Disease .
Benefits Of Oral Bicarbonate Therapy
Sodium bicarbonate naturally buffers retained acids in the body. Some clinicians believe that by increasing bicarbonate levels and enhancing the buffering effect, metabolic acidosis will decrease, along with many of its associated problems.
The first study I came across in support of this theory evaluated the effects of oral bicarbonate and muscle strength in 20 people with chronic kidney disease and mild acidosis. They were treated during successive two-week periods with a placebo followed by increasing oral sodium bicarbonate doses.6 In this short, small study, the results showed a dose-dependent increase in serum bicarbonate and improvement in lower extremity muscle strength.6
Interestingly, higher bicarbonate doses were not associated with increased blood pressure or greater edema. This is an important point, as doctors fear oral bicarbonate may raise blood pressure.6
A second study randomly assigned 134 people with chronic kidney disease to either oral sodium bicarbonate or standard-of-care for two years. The researchers followed the subjects creatinine clearance and nutritional parameters, such as dietary protein intake.7
The researchers concluded that oral bicarbonate supplementation slows the rate of decline of creatinine clearance and helps to improve nutritional parameters. Additionally, they were able to show that subjects taking bicarbonate were significantly less likely to experience a rapid decline in kidney function.7
The authors concluded:
Remove Stubborn Carpet Stains
A combination of baking soda and vinegar can remove the most stubborn carpet stains.
When baking soda and vinegar are mixed, they create a compound called carbonic acid, which is a common ingredient in cleaning products. This reaction creates a lot of fizzing, which may help break down tough stains .
Heres how you can eliminate stubborn carpet stains with just baking soda and vinegar:
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Barna, P. Sodium bicarbonate: burst stomachs and high sodium. J Clin Gastroenterol 1986;8:697-698. View abstract.
Bjornson DC, Stephenson SR. Cisplatin-induced massive renal tubular failure with wastage of serum electrolytes. Clin Pharm 1983;2;80-3. View abstract.
Braat MCP, Jonkers RE, Bel EH, Van Boxtel CJ. Quantification of theophylline-induced eosinopenia and hypokalamia in healthy volunteers. Clin Pharmacokinet 1992;22:231-7.. View abstract.
Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997;51:1867-75.. View abstract.
Brady JP, Hasbargen JA. Correction of metabolic acidosis and its effect on albumin in chronic hemodialysis patients. Am J Kidney Dis 1998;31:35-40. View abstract.
Brar, S. S., Hiremath, S., Dangas, G., Mehran, R., Brar, S. K., and Leon, M. B. Sodium bicarbonate for the prevention of contrast induced-acute kidney injury: a systematic review and meta-analysis. Clin J Am Soc Nephrol 2009;4:1584-1592. View abstract.
Brater DC, Kaojarern S, Benet LZ, et al. Renal excretion of pseudoephedrine. Clin Pharmacol Ther 1980;28:690-4. View abstract.
Brismar B, Strandberg A, Wiklund B. Stomach rupture following ingestion of sodium bicarbonate. Acta Chir Scand Suppl 1986;530:97-9. View abstract.
Carr MM, Smith RL. Ceruminolytic efficacy in adults versus children. J Otolaryngol 2001;30:154-6. View abstract.
What If I Have An Ulcer
Baking soda, as well as OTC antacids, can temporarily relieve the symptoms of stomach ulcers. However, antacids are not a cure for stomach ulcers.
This is because stomach ulcers are most often a result of nonsteroidal anti-inflammatory drugs , such as ibuprofen, or Helicobacter pylori, which is a type of bacteria.
For ulcers due to NSAID use, people may need to lower or stop NSAID use. For ulcers due to H. pylori, a person may require antibiotics.
Antacids, including baking soda, can prevent antibiotics from working. While a person receives ulcer treatment, a doctor can prescribe other drugs such as proton pump inhibitors to reduce stomach ulcer symptoms and allow the ulcer to heal.
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Are Potatoes Bad For Kidneys
Sweet potatoes also contain vitamins and minerals, such as potassium, that may help balance the levels of sodium in the body and reduce its effect on the kidneys. However, as sweet potato is a high-potassium food, anyone who has CKD or is on dialysis may wish to limit their intake of this vegetable.
Side Effects Of Sodium Bicarbonate
Common side effects of sodium bicarbonate include belching and flatulence.2 It is important to note that higher doses may cause fluid retention and worsen blood pressure control with CKD patients. Sodium bicarbonate may also reduce serum potassium. This can be beneficial for people with later stages of CKD who are at risk of high potassium levels.
Look for more information on metabolic acidosis and sodium bicarbonate, including diets role in acidosis in my next blog post coming in April.
There are 30 million adults with kidney disease in the U.S. Take the risk quiz to learn more about kidney disease risk factors.
Visit DaVita.com and explore these diet and nutrition resources:
- Kidney Smart®Classes taught by kidney experts in your area
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How To Dissolve Kidney Stones Quickly With Baking Soda
Kidney stones develop in the due course of time and tend to create a lot of pain. They are, basically, solid masses formed due to constant deposits of mineral salt or organic substance. At times, the deposits turn out to be larger enough to get stuck in ureter leading to renal failure. Ever thought as to what causes the occurrence of kidney stones? It is the excessive intake of Vitamin D, constant urinary tract infections, dehydration, unhealthy diet, stress and imbalance of minerals in the body adds to the cause list.
Baking Soda Remedy For Kidneys
According to www.santeplusmag.com, studies conducted at the Royal Hospital in London have shown that baking soda has a beneficial effect on kidney function and slows the formation of kidney stones.;In addition, this food can help people on dialysis.;The study, which lasted 2 years, included patients on dialysis.;They were given baking soda.;At the end of the study, the results were truly astonishing: only 6.5% of patients consuming bicarbonate still needed dialysis.
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What Evidence Provides Substantial Proof Of This Claim
The US National Health Institutes conducted studies that first noted the effectiveness of sodium bicarbonate dialysis in the place of normal, acetate-free biofiltration dialysis. Patients place on the SBD treatment had greater nitrate oxide synthase, the process that balances the pH of your blood. Patients on normal acetate-free biofiltration had a lower reaction than BHD in activating vessel wall cells to synthesis/release of pro-inflammatory and pro-apoptotic mediators.
Additionally, other studies done by Dr. Ione de Brito-Ashurst and his colleagues from the Department of Renal Medicine and Transplantation showed that daily sodium bicarbonate intake slows the progress of chronic kidney disease and prevent patients from ever having to undergo kidney dialysis.
This randomized controlled trial showed that patients who were given a minor daily dose of SB during a yearlong period had only 2/3 of the kidney function decline shown in patients given standard kidney disease treatment. In short, sodium bicarbonate can prevent and in some cases reverse the onset of chronic kidney failure and stop related diseases like heart disease and end-stage renal disease.
How To Use Sodium Bicarbonate For Kidney Damage
Talk to a health care professional before starting any type of treatment. Sodium bicarbonate; is not toxic, but it can be difficult for a sensitive stomach to digest. Proper administration for those in danger of developing kidney disease includes:
Kidney damage can be caused by living an unhealthy lifestyle, so the best way to protect your kidneys is to maintain a healthy weight and a healthy diet! Check out the video below for a baking soda and apple cider vinegar drink you can make at home!
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How Does Bicarbonate Repair Kidneys
When those with significant kidney damage undergo dialysis or kidney treatment, sodium bicarbonate is one of the most common agents used. This process, known as acid buffering, is means of base supplementation and is the basis for most new forms of dialysis treatments. This agent, when processed through the dialysis machine, helps in the removal of excess fluids and waste material from your bloodstream.
Therefore, dialysis is helping add the sodium bicarbonate that your kidneys can no longer produce into your endocrine system to help you process food and waste materials in your bloodstream. When your body is producing normal amounts of bicarbonate on its own, this can extend the life of your kidneys, your overall endocrine system, and your total lifespan.
What Are Bicarbonate And Serum Bicarbonate
Bicarbonate is a substance called a base, which the body needs to help keep a normal acid-base balance. This balance prevents your body from becoming too acid, which can cause many health problems. The lungs and kidneys keep a normal blood pH by removing excess acid.
Serum bicarbonate mostly travels throughout the body as carbon dioxide , a gas that’s dissolved in the blood. That’s why the amount of CO2 in your blood is used to measure serum bicarbonate , and to therefore check your acid-base balance. If CO2 is too low in your blood, then that means serum bicarbonate is low, and your body has too much acid. Too much acid in the body is called metabolic acidosis.
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How Does Baking Soda Work In Getting Rid Of Kidney Stones
Baking soda alkalizes the urine to dissolve the uric acid stones or calcium oxalates, which block the narrow renal tubes connecting the kidneys with the bladder. Regular intake of baking soda decreases the uric acid and cystine present in the urine to effectively prevent kidney stones. Also, the kidneys are extremely sensitive to balance of ionic constituents and urine acidity. High level of urine acidity triggers the formation of kidney stones. Baking soda helps to restore the normal pH balance of the kidney to promote its proper functioning and prevent the formation of kidney stones.
Where Are Bicarbonates Created In The Human Body And Why
The chloride ion from the sodium chloride binds to an acid or proton forming HCL as a waste product of sodium bicarbonate production. HCL has a pH of 1 and is highly toxic to the blood and tissues and the cause of indigestion, acid reflux, ulcers, diabetes, cancer, hyponatremia, edema, tonsilar herniation and death. When large amounts of acids, including HCL, enter the stomach from a rich animal protein or dairy product meal, such as meat and cheese, or from starchy foods from root vegetables like potatoes or during extreme exercise, acid is withdrawn from the acid-base household. The organism would die if the resulting alkalosis – or NaHCO3 or base surplus – created by the stomach was not taken up by the alkalophile glands that need these quick bases in order to build up their strong sodium bicarbonate secretions. These alkalizing glands and organs are the stomach, pancreas, Brunner’s glands , Lieberkuhn’s glands in the liver and its bile with its strong acid binding capabilities which it has to release on the highly acidic meat, cheese, potato, acid water or metabolic and/or respiratory acids from over-exercise to buffer its strong acids of nitric, sulphuric, phosphoric, uric and lactic acids in daily metabolism, respiration and excessive or over-exercise.
Bicarbonate acts to stimulate the ATPase by acting directly on it .
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What Studies Are Saying
The US National Health Institute has conducted experiments that show that kidney dialysis using bicarbonate agents have more restorative properties than standard dialysis treatments.
In addition, British scientists at the Royal Hospital in London conducted a study on the relationship between bicarbonate and slowing the progression of kidney disease.
Out of 134 test patients with advanced kidney disease and metabolic acidosis, a randomly selected small group was given a tablet daily, made of a small amount of sodium bicarbonate for a year. The kidney function of these patients declined at a rate thats expected with normal aging and were less likely to require dialysis. This group had a 2/3 slower decline of health than the untreated group. Patients taking sodium bicarbonate were also less likely to develop end-stage renal disease requiring dialysis. ;via ScienceDaily
Professor Magdi Yaqoob, lead researcher of the British study, explained in a press release:
Its amazing. This is the first randomized controlled study of its kind. A simple remedy like sodium bicarbonate, when used appropriately, can be very effective.
This study shows baking soda can be useful for people with kidney failure. That is, as long as the dose is regulated and under supervisionWhat happens is the inflammation of kidney is prevented by baking soda because a chemical reaction takes place limiting ammonia production in the kidney.
What About Sodium Bicarbonate Tablets
Sodium bicarbonate is a common supplement used to help treat low serum CO2 levels. It usually comes in a tablet form that is taken 1-2 times per day.
In the research it shows up very comparable to a high fruit and vegetable intake. We recommend a food first approach but also realize that there are many situations where having a bicarbonate tablet could be very helpful.
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How Do You Know If You Have Metabolic Acidosis
Metabolic acidosis in CKD is measurable. On your blood work there is a level called the serum bicarbonate or CO2 level. Thenormal range defined on your lab results probably will say 20-30. For sure, if youre serum CO2 is below 20 then you are dealing with metabolic acidosis. But even if the lab doesnt show up as out of range, you should be watching it closely.;
Why? The therapeutic goal for CO2, per the current research may very well be higher than 20. This means that even if your serum CO2 level looks normal it may not be optimal to preserve kidney function.
How Does The Body Balance The Acid/alkaline Environment
Kidneys are a KEY organ in managing the pH in our blood. Im not going to dig into all the science here because it is complicated and involves anion gaps and a load of chemistry. What you need to understand more or less is that as kidney function declines the ability of the kidney to get rid of acid and/or balance acid is severely hampered.;
This means you need to know what you can do to support the acid/base balance in your body if your kidney function is decreased. And, yes, diet or supplements are a factor.
First, though, lets talk about your labs.
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What Questions Should You Ask Your Doctor About Sodium Bicarbonate
Before taking any supplement you should talk with your doctor. Sodium bicarbonate tablets are meant to help with metabolic acidosis. If your serum CO2 levels look great, there is no additional benefit to having sodium bicarbonate.
If your CO2 levels are trending down then youll need to talk with your doctor about how much sodium bicarbonate to take. If you need a higher dose, one of the great things about Bicarbi is that they have they have a double-strength product that can help cut down on the number of pills you need to take without additional any side-effects. Generally people take 1 tablet twice daily but it is individualized for every person.