Efficacy of urine alkalinization by oral administration of sodium bicarbonate: a prospective open-label trial.
BACKGROUND
Urine alkalinization is indicated for various medical conditions. Alkalinization is usually achieved by intravenous administration of alkali substances titrated by repeated urinalyses. Some situations such as mass casualty events might require urine alkalinization by the oral route. We evaluated the efficacy of oral sodium bicarbonate administration for urine alkalinization.


METHODS
In a prospective open-label trial, 4 g of sodium bicarbonate was administered orally 3 times daily to 9 healthy volunteers for 24 hours. Serial blood and urine samples were collected, and urine pH was evaluated. Plasma electrolytes and pH were also measured for safety purposes.


RESULTS
All participants had a urine pH of at least 7 after 10 hours. At 20 hours, all participants had a urine pH of at least 8. No adverse effects or abnormal blood results were documented during the 24-hour follow-up.


CONCLUSIONS
Oral administration of a standard dose of sodium bicarbonate tablets resulted in effective urine alkalinization. Further research is needed to investigate the natural course of urine pH after cessation of our protocol and the efficacy of longer periods of treatment.
CBRN (Chemical, Biological, Radiological, Nuclear) Medicine Branch, Medical Corps, Israel Defense Forces (IDF), Jerusalem, Israel. Electronic address: barakcohen1978@gmail.com.
Barak
B
Cohen
Ido
I
Laish
Tal
T
Brosh-Nissimov
Azik
A
Hoffman
Lior H
LH
Katz
Rony
R
Braunstein
Ram
R
Sagi
Goldman
G
Michael
D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control; D000284:Administration, Oral; D000328:Adult; D003444:Crush Syndrome / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000494:pharmacology*; D014556:Urine / Q000737:chemistry*; D055815:Young Adult
D017693:Sodium Bicarbonate