Indications
Sodium Hydrogen Carbonate (sodium bicarbonate) in this form is a concentrated solution or powder used to prepare the fluid for haemodialysis, the machine treatment that cleans the blood when the kidneys have failed. It supplies bicarbonate, a natural buffer, to the dialysis fluid so that excess acid in the blood can be corrected during each session.
How It Works
The dialysis machine mixes this bicarbonate concentrate with a separate acid concentrate and specially purified water to make the final dialysis fluid. During treatment, bicarbonate passes across the dialyser membrane into the blood. Bicarbonate neutralises acids that build up when the kidneys cannot remove them, helping to bring the blood’s acid level (pH) back towards normal.
Dosage and Administration
This product is used only by trained dialysis staff in a hospital or dialysis centre, on a dialysis machine set up for bicarbonate dialysis. The bicarbonate level, mixing ratio, length and frequency of sessions are set by the kidney doctor for each patient. It must never be injected or swallowed directly.
Interactions
The concentrate itself is not a medicine taken by the patient, but the dialysis prescription is planned around other treatments. Tell the dialysis team about all medicines, including oral sodium bicarbonate or other alkali tablets, Calcium supplements, diuretics and Digoxin, because changes in acid level and potassium during dialysis can alter how these work.
Contraindications
It must not be used by injection or by mouth, and must not be used on its own without the matching acid concentrate. The dialysis team will adjust or avoid high bicarbonate levels in patients who already have too much alkali in the blood (metabolic alkalosis) or very low potassium or calcium.
Side Effects
Problems linked to the bicarbonate part of dialysis are uncommon when the machine is set correctly. Possible effects include:
- Too much alkali in the blood, which can cause muscle twitching, tingling or cramps
- Low potassium or low calcium levels
- Headache, nausea, tiredness or low blood pressure during dialysis
Tell the dialysis staff at once if you feel chest pain, an irregular heartbeat, severe cramps, confusion, breathlessness or faintness during or after a session.
Pregnancy and Lactation
Dialysis with bicarbonate fluid can be continued during pregnancy and breastfeeding; women who are pregnant usually need longer or more frequent sessions planned closely by the kidney doctor and obstetrician.
Precautions and Warnings
The concentrate must be correctly matched to the acid concentrate and machine setting; a wrong mix can cause dangerous changes in blood salts. Use only purified dialysis-grade water. Bicarbonate solutions can grow bacteria and lose carbon dioxide once opened, so they should be used within the time stated on the pack. Blood tests are checked regularly to fine-tune the prescription.
Overdose
Too much bicarbonate during dialysis can lead to alkalosis, with symptoms such as cramps, tingling, confusion or slow breathing. The dialysis team will stop or adjust the treatment and correct blood levels.
Therapeutic Class
Haemodialysis solution (bicarbonate buffer concentrate).
Storage
Store as directed on the pack, at room temperature below 30°C, in a dry place away from light. Do not freeze. Keep containers closed until use and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.