The Effect of Oral Sodium Bicarbonate on the Improvement of Interdialytic Acidosis and Hyperkalemia

Abstract Background Uraemic toxins closely fitting the saw-toothed profile including electrolytes, such as potassium, which is statistically associated with peri-dialytic morbidity and mortality. Acidosis follows a similar inverse pattern, with the bicarbonate levels gradually falling during the inter-dialytic period, before rapid supplementation during dialysis. Observational studies of clinical outcome support the view that acidosis is harmful, showing that, after adjustment for comorbidity, pre-dialysis bicarbonate levels below 22 mmol/L are associated with excess mortality. Aim of the Work to understand the effect of oral sodium bicarbonate supplementation on patients on regular hemodialysis on improvement of inter-dialytic acidosis, and hyperkalemia Patients and Methods This was a one arm interventional study that was conducted on a group of 50 ESRD patients on regular hemodialysis 3 times/ week for at least 3 months. Results In the current study, mean ± SD of age (years) was 41.8 ± 10.5. Males and females were 58.0% and 42.0% respectively. In this study, systolic blood pressure (mmHg) before, and after sodium bicarbonate supplementation as well as its change was 123.8 ± 11.4, 125.6 ± 14.3 and 1.8 ± 9.4 respectively. The change was statistically non-significant. Diastolic blood pressure (mmHg) before, and after sodium bicarbonate supplementation as well as its change was 76.0 ± 7.6, 77.0 ± 8.1 and 1.0 ± 9.5 respectively. The change was statistically non- significant. This study showed that, Na (mmol/L) before, and after sodium bicarbonate supplementation as well as its change was 137.3 ± 4.6, 137.6 ± 4.6 and 0.3 ± 1.6 respectively. The change was statistically non-significant. Conclusion Oral sodium bicarbonate supplementation is effective in correcting metabolic acidosis, and does not cause increased interdialytic body weight gain, different plasma sodium concentrations and different systolic-diastolic blood pressure levels.