Sodium Bicarbonate Metabolic Acidosis Treatment Algorithm
Metabolic Acidosis in CKD: Core curriculum 2019; Kalani Raphael
AJKD, Vol 74 |Iss 2| August 2019
Case studies on the importance of serum bicarbonate using the 8 Variable Kidney Failure Risk Equation.
In this section you will find three case studies for nephrologists, other health care providers and patients which show the importance of properly managing metabolic acidosis. These case studies highlight the potential differences in the progression of chronic kidney between different levels of serum bicarbonate (Total CO2). The three case studies in CKD stages 3, 4, & 5 were developed using the 8 variable kidney failure risk equation. More about the equation can be found below.
Kidney Failure Risk Equation.
The progression of kidney disease is dependent on multiple factors. The kidney failure risk equations in the estimator were developed in patients with CKD stages 3-5 referred to nephrologists in Canada, and have now been validated in more than 700,000 individuals spanning 30 + countries worldwide
Nephcentric has had no influence in the development of the equation, nor does nephcentric make any claims on the accuracy of the estimator. It is a tool for users to calculate an estimated risk for the progression of kidney disease, including the individual variable of serum bicarbonate (Total CO2) and the potential benefit on kidney disease progression of improved serum bicarbonate.
To use the estimator you will need to input the following variables: 1-Sex/Gender, 2 - Age, 3 - eGFR or estimated GFR, 4 - Urine Albumin Creatinine Ratio, 5 - Serum Calcium, 6 - Serum Phosphorus, 7 - Serum Bicarbonate (Total CO2), & 8 - Serum Albumin.
To estimate the difference in 2 year and 5 year kidney disease progression for the variable serum bicarbonate (Total CO2), you will need to input your current 8 variables including your current serum bicarbonate. Then you will need to change serum bicarbonate to your goal. This number should be between 23-29 mEq/L. The difference in 2 and 5 year risk from your current serum bicarbonate to your goal will be your potential reduction in risk of progression for the individual variable of serum bicarbonate.