SAN DIEGO—Oral sodium bicarbonate may ease hyperphosphatemia in peritoneal dialysis (PD) patients with metabolic acidosis, researchers reported at Kidney Week 2012.

Subir K. Paul, MD, and colleagues at Shoals Kidney & Hypertension Center in Florence, Ala., studied 13 PD patients with metabolic acidosis (serum bicarbonate below 22 mEq/L). Sodium bicarbonate was given orally with a total dose of 3,900 mg daily for one month. No change was made in dietary phosphate restriction.

During the treatment phase, serum bicarbonate worsened from 21.4 to 19 mEq/L in four weeks. With oral sodium bicarbonate, serum bicarbonate improved significantly from 19 to 24.9. Prior to treatment, serum phosphate rose significantly from 5.9 to 7.3 mg/dL. With treatment, it decreased significantly from 7.3 to 5.4 mg/dL. Calcium-phosphorus product increased from 54.4 to 63.7 prior to treatment, but decreased significantly from 67.7 to 50.4 after treatment. Results showed that 69% of treated patients had phosphate levels below 5.5 and calcium-phosphate product below 55, which are the target levels recommended by guidelines developed under the Kidney Disease Outcomes Quality Initiative.

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The investigators concluded that oral sodium bicarbonate treatment corrects metabolic acidosis in PD patients and may be therapeutically beneficial in the management of hyperphosphatemia.