Aiming for the optimal bicarbonate prescription for maintenance hemodialysis therapy in end‐stage renal disease

Abstract

The impact of conventional HC03^- concentrations of 35 mmol/L results in a considerable degree of pre-dialysis acidemia. Increasing the HC03^- in bath results in more prominent post-dialysis alkalemia, however, it is not sufficient to maintain acid-base status during the interdialytic period. Oral bicarbonate supplement at a dose of 5 g/day (divided in three daily doses) results in a more balanced acid-base status, avoiding post-dialysis alkalemia.