sodium bicarbonate or sodium citrate

[okarol]

The nephrologist has Jenna taking liquid sodium citrate twice a day. His nurse said it is to balance out her carbon dioxide level, which is low. I tried to find out more info on the internet but all I see is that it is used to reduce kidney stones, which is not an issue for her. Does anyone take it and can you explain what it does?
 

[Bill Peckham]

http://www.advancedrenaltechnologies.com/

Citrasate® from Advanced renal Technologies? The only time I've seen that used is instead of bicarb dialysate, in that case it allows no heparin dialysis.

Is Jenna taking it by mouth? Who makes it?

[okarol]

It's a liquid - label says 420 Sod Citrate/Citric Acid Soln Pa GEN for Bicitra SF
Take 2 Tablespoons By Mouth 2 Times Daily

[Yvonne]

John was put on a tablet form, has been on it now for 3 years 2 tablets twice a day.  It's called Sodium Bicarbonate Capsules 500 mg I though it just helps airiate the blood !!!!!

[okarol]

Hubby said he thinks it's for Metabolic Acidosis - Jenna's ph is 6.5, which is apparently acidic, which correlates with the low CO2 level - so I guess it will help. http://en.wikipedia.org/wiki/Metabolic_acidosis
I never heard of it before.

[chiefsfan301]

I take 650mg three times a day, I though it was to give the pharmacy more money for a do nonthing pill.

[RightSide]

If you're only mildly acidotic,
the hemodialysis machine can buffer the blood sufficiently.

I was severely acidotic, and took bicarb till my blood pH rose enough for the hemodialysis machine to take over the job.  I haven't taken bicarb in a year now.

[okarol]

Yeah, that makes sense. She isn't on dialysis yet but her GFR is 14.

[Meinuk]

I was on Bicitra for 2 years for my acidosis. We were very aggressive with my meds when my GFR hit 15.  I stayed at 15 for almost 5 years. Between the Bicitra, modified diet (Except I replaced protein with carbs and packed on weight) and other meds, it worked really well.  I'd have to look at my notes for my dosages but I think it was BID po (twice a day by mouth).  It tasted terrible.

I was curious, so I just pulled my pre dialysis labs (doesn't everyone have a full copy of their medical records? or am I a freak - that question was rhetorical... I already know the answer.) 

The Bicitra made a difference for a couple of years.   

My Co2 range was:

1/04   14
5/05   18 (w/ Bicitra therapy)
5/06   24 (w/ Bicitra);
1/07   12  (w/ Bicitra) my last labs before dialysis started

I just read Ken's post, and I'll update with my corresponding potassium numbers in that time period:

1/04     5.6
5/05     4.7
5/06     4.8
1/07     4.3


Thinking of you.

 

[Ken Shelmerdine]

Karol is Jenna'a potassium within normal levels? If it is borderline then ph can become slightly acidic and prescribing sodium bicarb not only brings ph toward neutral but it has the affect of  lowering serum potassium levels too.

As general rule of thumb it's is like a see saw action (ei) if bicarbonate drops then serum potassium rises and vice versa. I havn't heard of treating PH acidity with sodium citrate though.

I fizz along taking 9!! sodium bicarbe per day  to keep my bicarb about 22 and potassium about 5.1

[BASSMAN]

I have been on it for over a year now.  Google "sodium bicarb preserves kidney function".

[okarol]

Thanks everyone. I appreciate the help. The liquid has to be mixed with a beverage and Jenna said it's not too bad. A pill sure would be easier.
I came across the article from last year that Rose had posted:
Daily dose of baking soda ‘can keep kidney patients off dialysis
http://ihatedialysis.com/forum/index.php?topic=14834.0

[Stoday]

I've been prescribed 500mg capsules of Sodium Bicarbonate earlier this year. So tablets are available.

Made by Focus Pharmaceuticals Ltd in the UK.

[Meinuk]

Karol, be careful what she mixes the Bicitra with.  My pharmacist (who's 8 year old daughter received one of his wife's kidneys) told me to only mix it with water, as water is inert, no chemical reaction until the medicine is in my system.

[Joe Paul]

Hubby said he thinks it's for Metabolic Acidosis - Jenna's ph is 6.5, which is apparently acidic, which correlates with the low CO2 level - so I guess it will help. http://en.wikipedia.org/wiki/Metabolic_acidosis
I never heard of it before.

My blood is acidic, post transplant, and my potassium level runs at 5, they say this pill should help keep potassium and acid levels within range.
  .

[okarol]

Karol, be careful what she mixes the Bicitra with.  My pharmacist (who's 8 year old daughter received one of his wife's kidneys) told me to only mix it with water, as water is inert, no chemical reaction until the medicine is in my system.

Wow, good to know since Jenna has had it with orange juice a few times.