The Curbsiders Internal Medicine Podcast #430 CKD, Metabolic Acidosis, Baking Soda vs Fruits and Veggies. It’s NephMadness 2024!
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Mar 11, 2024 Exploring the management of metabolic acidosis in CKD, discussing bicarbonate supplementation, alternative options like baking soda and fruits/veggies, dietary modifications, counseling CKD patients, common mistakes, and pitfalls. Dr. Timothy Yau shares insights, focusing on optimizing care and the use of sodium bicarbonate. NephMadness 2024 adds to the excitement with a pod crawl event for internists and intensivists.
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Tim Yau's Musical And Gaming Side
- Tim Yau plays multiple instruments and has focused on traditional Irish music for a decade.
- He also plays video games and recently downloaded the Boygenius album.
Prioritize High-Value CKD Interventions
- Prioritize ACE/ARB use and blood pressure and glycemic control over treating mild metabolic acidosis.
- Consider addressing bicarbonate after higher-priority CKD interventions are optimized.
Mechanism Linking Acidosis To CKD Progression
- Kidneys (and lungs/bones) manage acid load; reduced nephron mass limits ammonium excretion and new bicarbonate generation.
- Chronic acidosis upregulates angiotensin II, aldosterone and endothelin, promoting fibrosis and CKD progression.