Should oral sodium bicarbonate be used to prevent chronic kidney disease progression?

In the October edition of Irish Medical Journal (IMJ), our group identified the high burden of metabolic acidosis of chronic kidney disease (MA-CKD) in nephrology outpatient setting at a tertiary centre. After adjusting for potential contraindication, only 19% of the eligible patients were on oral sodium bicarbonate (OSB). We are for the first time reporting the preliminary results from our ongoing study aiming to identify the practice of prescribing OSB in the management of MA-CKD in patients with serum bicarbonate levels below 22mmol/L from the majority of the nephrology centres across the Republic of Ireland using the national renal database (eMED). Initial results indicate 267 patients had serum bicarbonate level below 22mmol/L of which 57 (22.1%) were on OSB, during the study period between 2018-2019. This multicentre cohorts’ initial results correlate with our previously published work suggesting limited usage of OSB in practice.