Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis
Metabolic acidosis occurs when a relative accumulation of plasma anions in excess of cations reduces plasma pH. Replacement of sodium bicarbonate to patients with sodium bicarbonate loss due to diarrhea or renal proximal tubular acidosis is useful, but there is no definite evidence that sodium bicar...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2014/627673 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832545603538649088 |
|---|---|
| author | María M. Adeva-Andany Carlos Fernández-Fernández David Mouriño-Bayolo Elvira Castro-Quintela Alberto Domínguez-Montero |
| author_facet | María M. Adeva-Andany Carlos Fernández-Fernández David Mouriño-Bayolo Elvira Castro-Quintela Alberto Domínguez-Montero |
| author_sort | María M. Adeva-Andany |
| collection | DOAJ |
| description | Metabolic acidosis occurs when a relative accumulation of plasma anions in excess of cations reduces plasma pH. Replacement of sodium bicarbonate to patients with sodium bicarbonate loss due to diarrhea or renal proximal tubular acidosis is useful, but there is no definite evidence that sodium bicarbonate administration to patients with acute metabolic acidosis, including diabetic ketoacidosis, lactic acidosis, septic shock, intraoperative metabolic acidosis, or cardiac arrest, is beneficial regarding clinical outcomes or mortality rate. Patients with advanced chronic kidney disease usually show metabolic acidosis due to increased unmeasured anions and hyperchloremia. It has been suggested that metabolic acidosis might have a negative impact on progression of kidney dysfunction and that sodium bicarbonate administration might attenuate this effect, but further evaluation is required to validate such a renoprotective strategy. Sodium bicarbonate is the predominant buffer used in dialysis fluids and patients on maintenance dialysis are subjected to a load of sodium bicarbonate during the sessions, suffering a transient metabolic alkalosis of variable severity. Side effects associated with sodium bicarbonate therapy include hypercapnia, hypokalemia, ionized hypocalcemia, and QTc interval prolongation. The potential impact of regular sodium bicarbonate therapy on worsening vascular calcifications in patients with chronic kidney disease has been insufficiently investigated. |
| format | Article |
| id | doaj-art-c815ef65bd5043f3b36e3687bdae3079 |
| institution | Kabale University |
| issn | 2356-6140 1537-744X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-c815ef65bd5043f3b36e3687bdae30792025-02-03T07:25:24ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/627673627673Sodium Bicarbonate Therapy in Patients with Metabolic AcidosisMaría M. Adeva-Andany0Carlos Fernández-Fernández1David Mouriño-Bayolo2Elvira Castro-Quintela3Alberto Domínguez-Montero4Nephrology Division, Hospital General Juan Cardona, Avenida Pardo Bazán, s/n, Ferrol, 15406 A Coruña, SpainNephrology Division, Hospital General Juan Cardona, Avenida Pardo Bazán, s/n, Ferrol, 15406 A Coruña, SpainNephrology Division, Hospital General Juan Cardona, Avenida Pardo Bazán, s/n, Ferrol, 15406 A Coruña, SpainNephrology Division, Hospital General Juan Cardona, Avenida Pardo Bazán, s/n, Ferrol, 15406 A Coruña, SpainNephrology Division, Hospital General Juan Cardona, Avenida Pardo Bazán, s/n, Ferrol, 15406 A Coruña, SpainMetabolic acidosis occurs when a relative accumulation of plasma anions in excess of cations reduces plasma pH. Replacement of sodium bicarbonate to patients with sodium bicarbonate loss due to diarrhea or renal proximal tubular acidosis is useful, but there is no definite evidence that sodium bicarbonate administration to patients with acute metabolic acidosis, including diabetic ketoacidosis, lactic acidosis, septic shock, intraoperative metabolic acidosis, or cardiac arrest, is beneficial regarding clinical outcomes or mortality rate. Patients with advanced chronic kidney disease usually show metabolic acidosis due to increased unmeasured anions and hyperchloremia. It has been suggested that metabolic acidosis might have a negative impact on progression of kidney dysfunction and that sodium bicarbonate administration might attenuate this effect, but further evaluation is required to validate such a renoprotective strategy. Sodium bicarbonate is the predominant buffer used in dialysis fluids and patients on maintenance dialysis are subjected to a load of sodium bicarbonate during the sessions, suffering a transient metabolic alkalosis of variable severity. Side effects associated with sodium bicarbonate therapy include hypercapnia, hypokalemia, ionized hypocalcemia, and QTc interval prolongation. The potential impact of regular sodium bicarbonate therapy on worsening vascular calcifications in patients with chronic kidney disease has been insufficiently investigated.http://dx.doi.org/10.1155/2014/627673 |
| spellingShingle | María M. Adeva-Andany Carlos Fernández-Fernández David Mouriño-Bayolo Elvira Castro-Quintela Alberto Domínguez-Montero Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis The Scientific World Journal |
| title | Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis |
| title_full | Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis |
| title_fullStr | Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis |
| title_full_unstemmed | Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis |
| title_short | Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis |
| title_sort | sodium bicarbonate therapy in patients with metabolic acidosis |
| url | http://dx.doi.org/10.1155/2014/627673 |
| work_keys_str_mv | AT mariamadevaandany sodiumbicarbonatetherapyinpatientswithmetabolicacidosis AT carlosfernandezfernandez sodiumbicarbonatetherapyinpatientswithmetabolicacidosis AT davidmourinobayolo sodiumbicarbonatetherapyinpatientswithmetabolicacidosis AT elviracastroquintela sodiumbicarbonatetherapyinpatientswithmetabolicacidosis AT albertodominguezmontero sodiumbicarbonatetherapyinpatientswithmetabolicacidosis |