Randomized Trial on the Efficacy and Safety of Standard Versus Higher Bicarbonate Supplementation in CKD of Unknown Etiology

A bicarbonate level of less than 22 meq/l is associated with an increased risk for CKD progression, reduced bone mineral density, loss of muscle mass, and all-cause mortality 1. Many previous studies have shown that bicarbonate supplementation in the dose range of 0.3-0.5 meq/Kg Body Weight (KBW) is safely tolerated, raising the feasibility of escalating the doses to 0.8 meq/KBW in subsequent clinical trials 2. Observational data suggests a survival benefit when bicarbonate levels in 26-28 meq/L range 1 .