What is the role of sodium bicarbonate in the treatment of acute kidney injury (AKI)?

Updated: Dec 24, 2020
  • Author: Biruh T Workeneh, MD, PhD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In patients who are at high risk for volume overload—in particular, those with chronic heart failure who have a left ventricular ejection fraction of less than 40%—isotonic NaHCO3 solution should be administered before and after the procedure. It can be prepared by mixing 3 ampules of NaHCO3 in a liter of 5% dextrose in water (D5W) and can be given at a rate of 3 mL/kg/h for 1 hour prior to the procedure, with the rate decreased to 1 mL/kg/h during the procedure and for 6 hours afterward.


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