Nephro Flashcards
Acidosis indication for bicarb correction
severe acidemia (pH <7.10) in an adult patient (especially the elderly and patients with severe heart disease) - IV administration of 50 meq of NaHCO3 diluted in 300 mL of sterile water over 30–45 min, during the initial 1–2 h of therapy
Diabetic ketoacidosis - presence of severe acidosis (arterial pH <7.0), the ADA advises bicarbonate (50 mmol [meq/L] of sodium bicarbonate in 200 mL of sterile water with 10 meq/L KCl per hour for 2 h until the pH is >7.0
Aki- Metabolic acidosis is generally not treated unless severe (pH <7.20 and serum bicarbonate <15 mmol/L)
Ckd - The renal tubular acidosis and subsequent anion-gap metabolic acidosis in progressive CKD will respond to alkali supplementation, typically with sodium bicarbonate. Recent studies suggest that this replacement should be considered when the serum bicarbonate concentration falls below 20–23 mmol/L to avoid the protein catabolic state seen with even mild degrees of metabolic acidosis and to slow the progression of CKD.
