The Curbsiders Internal Medicine Podcast

#430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024!


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Is bicarbonate supplementation for metabolic acidosis in chronic kidney disease (CKD) a thing we do for no reason? We cover the pathophysiology and long-term consequences of metabolic acidosis, the history of bicarbonate use, alternative options for bicarbonate repletion including baking soda, lemon juice, fruits and veggies, whether the renal diet works, counseling patients with CKD, and common mistakes and pitfalls in managing metabolic acidosis in CKD. Our guest is Dr. Timothy Yau (@Maximal_Change, @WUNephrology, @AJKDOnline). It’s NephMadness 2024! Fill out your bracket today and check out the other podcasts participating in the NephMadness pod crawl!

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Show Segments

Time stamps refer to the ad-free version
  • 00:00 Introduction and Guest Bio
  • 07:46 Case Presentation
  • 08:42 Initial Approach to CKD Management
  • 09:10 Metabolic Acidosis in CKD
  • 13:30 Consequences of Metabolic Acidosis
  • 22:28 Administration of Bicarbonate
  • 23:54 Alternative Options for Bicarbonate Repletion
  • 24:47 Citrate and Bicarbonate
  • 26:02 Sodium Bicarbonate for CKD
  • 30:19 Dietary Modifications
  • 33:35 Renal Diet
  • 38:20 Counseling CKD Patients
  • 41:39 Veverimer and Other Treatments
  • 44:36 Mistakes and Pitfalls
  • 46:55 Conclusion

  • Credits

    • Writer and Producer: Matthew Watto MD, FACP
    • Show Notes: Matthew Watto MD, FACP
    • Cover Art and Infographic: Matthew Watto MD, FACP
    • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
    • Reviewer: Emi Okamoto MD
    • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
    • Technical Production: PodPaste
    • Guest: Timothy Yau MD

    • Sponsor: Rocket Money 

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