Use of Bicarbonate for Impaired Kidney Function

Bicarbonate is a naturally-occurring electrolyte, or electrically-charged salt that helps regulate blood acidity (pH level) in the body. The presence of bicarbonate in the bloodstream is partially controlled by the kidneys. In individuals with impaired kidney function, levels of bicarbonate may fall below normal, leading to a dangerous condition known as renal acidosis. Sodium bicarbonate, a man-made substance also called bicarbonate of soda, is commonly used to treat severe cases of this disorder.

Understanding the Importance of Bicarbonate

• Proper blood pH is crucial to metabolic functions within your body, and also promotes appropriate oxygen levels in your tissues. Under normal circumstances, blood pH measures between 7.35 and 7.45 on a scale of 0 to 14. When the presence of bicarbonate---an alkaline substance---is lower than usual in your bloodstream, you may begin to feel the effects of excess acidity, or acidosis. According to the peer-reviewed testing service Lab Tests Online, this occurs when pH falls below 7.35. If you experience acute---or sudden---renal acidosis, it can trigger symptoms including nausea, vomiting, headaches, confusion and seizures. At its worst, the condition can also induce coma and death. Renal acidosis can also trigger another potentially life-threatening disorder called hyperkalemia, which occurs when another electrolyte---potassium---builds up in the bloodstream. This buildup can lead to dangerous heartbeat irregularities. It is possible for you to develop renal acidosis with or without hyperkalemia.

Sodium Bicarbonate Treatment

• If testing or symptoms reveal the presence of renal acidosis or hyperkalemia, your doctor will work to restore your pH balance and electrolyte levels as quickly as possible. If your pH level is above 7.2, you may initially receive an alkaline solution containing a substance called potassium citrate. However, if your pH falls below 7.2, or your natural bicarbonate level is significantly diminished, sodium bicarbonate solution is the accepted treatment.

  When your pH level returns to normal, your acidosis symptoms will normally subside. Typically, when this occurs, excess potassium in your bloodstream is absorbed into your cells, leading to an end of hyperkalemia. Be aware that in some cases the effects of acidosis or hyperkalemia may be permanent.

  Although sodium bicarbonate is an effective substitute for natural bicarbonate, its effects in controlling acidosis are short-lived, and if your condition persists another form of treatment may be necessary. Sodium bicarbonate also contains significant amounts of salt, and its use may worsen symptoms in individuals who also suffer from acute kidney failure.

  In the long run, the best treatment for renal acidosis is a correction of the underlying problems inside your kidneys. Common causes of acidosis-related kidney impairment include hereditary disorders, autoimmune disease, and reaction to the use of medications such as lithium, amphotericin B and certain analgesics. If your kidney impairment is not well-controlled, you may experience future difficulties related to bicarbonate imbalance.