title: Current status of bicarbonate in CKD.
abstract: Metabolic acidosis was one of the earliest complications to be recognized and explained pathologically in patients with CKD. Despite the accumulated evidence of deleterious effects of acidosis, treatment of acidosis has been tested very little, especially with respect to standard clinical outcomes. On the basis of fundamental research and small alkali supplementation trials, correcting metabolic acidosis has a strikingly broad array of potential benefits. This review summarizes the published evidence on the association between serum bicarbonate and clinical outcomes. We discuss the role of alkali supplementation in CKD as it relates to retarding kidney disease progression, improving metabolic and musculoskeletal complications.
authors.affiliation: Division of Nephrology and Hypertension, Case Western Reserve University, University Hospital Case Medical Center, Cleveland, Ohio.
authors.forename: Mirela
authors.initials: M
authors.lastname: Dobre
authors.affiliation: Division of Nephrology and Hypertension, Case Western Reserve University, University Hospital Case Medical Center, Cleveland, Ohio.
authors.forename: Mahboob
authors.initials: M
authors.lastname: Rahman
authors.affiliation: Division of Nephrology and Hypertension, Case Western Reserve University, University Hospital Case Medical Center, Cleveland, Ohio Thomas.Hostetter@uhhospitals.org.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Hostetter
mesh_terms: D000138:Acidosis / Q000188:drug therapy / Q000209:etiology*; D000468:Alkalies / Q000627:therapeutic use*; D000818:Animals; D001639:Bicarbonates / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood; D019587:Dietary Supplements; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications*
chemical_list: D000468:Alkalies; D001639:Bicarbonates
keywords: acidosis; metabolism; progression of renal failure