EFFECT OF ORAL SODIUM BICARBONATE THERAPY ON PROGRESSION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH METABOLIC ACIDOSIS

Objective: To determine the effect of oral sodium bicarbonate therapy on the progression of chronic kidney disease in patients with metabolic acidosis and to evaluate its impact on renal function and clinical outcomes. Methods: This prospective comparative study was conducted at Lady Reading Hospital Peshawar from 11 January 2025 to 11 December 2025. A total of 110 patients with chronic kidney disease and metabolic acidosis were included using nonprobability consecutive sampling. Fifty five patients received oral sodium bicarbonate therapy in addition to standard treatment while fifty five patients received standard medical management alone. Baseline demographic characteristics and biochemical parameters were recorded and patients were followed regularly to assess changes in serum bicarbonate concentration renal function and progression of kidney disease. Data were analyzed using Statistical Package for Social Sciences version 26 and a p value of less than 0.05 was considered statistically significant. Results: The mean age of the study population was 54.6 ± 13.1 years and 68 patients were male. The mean baseline serum bicarbonate level was 18.5 ± 2.4 milliequivalents per liter. At the end of follow up the sodium bicarbonate group demonstrated significantly higher serum bicarbonate levels and better preservation of estimated glomerular filtration rate than the control group. Progression to stage five chronic kidney disease and requirement for dialysis were significantly lower among patients receiving bicarbonate therapy. Conclusion: Oral sodium bicarbonate therapy was associated with improvement in metabolic acidosis and delayed progression of chronic kidney disease. Early correction of acid base abnormalities may contribute to preservation of renal function and reduction in dialysis dependence.