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! Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME 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  Cancel your unwanted subscriptions by going to RocketMoney.com/CURB Sponsor: Freed You can try Freed for free right now by going to freed.ai And listeners of Curbsiders can use code CURB 50 for $50 off their first month.