Managing Acid Imbalance in CKD patients

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The kidneys manage acid balance

A major function of the kidneys is to manage acid balance. The body naturally produces acid from the daily diet and other metabolic processes. The kidneys normally keep the body in balance by excreting excess acid. Unfortunately, patients with chronic kidney disease start losing the ability to maintain this balance which leads to acid accumulation in the body. Acid imbalance generally begins slowly and progresses as kidney function declines. This is a vicious cycle of acid accumulation which leads to more damage to muscle, bone and kidneys as the body attempts to compensate for this imbalance. The administration of a base (also called alkali), such as sodium bicarbonate can counteract acid build up. Studies have demonstrated that early intervention with alkali slows kidney disease progression 1,3,9. Your health care provider will help you manage your diet and recommend an alkali such as RenaCarb, when appropriate. Reducing acid load is critical to breaking the cycle of acid imbalance and kidney health decline.

Knowing your risk for kidney disease

The CDC reports 37 million Americans have CKD and 90% do not know they have it. Early diagnosis and treatment directly affect outcomes. In a longitudinal retrospective study, Tangri et al. recently reported that adverse renal outcomes (eg. GFR decline, dialysis and mortality) were significantly higher among patients with metabolic acidosis vs. normal serum bicarbonate 11. Take charge of your kidney health with RenaCarb.

You can manage kidney disease with your health care providers guidance.

There is not a cure for CKD. However, there may be things you can do to slow the progression of kidney disease.

There are several strategies your health care provider may discuss with you. These may include dietary guidance, managing acid balance, blood pressure control, the use of angiotensin-converting-enzyme inhibitors and if appropriate, glycemic control. Always follow their guidance to improve your personal outcome.

Although early acid imbalance is generally without noticeable symptoms, the consequence to your muscle, bones and kidneys can be serious6.

RenaCarb is the right alkali to manage acid imbalance

Acid imbalance is part of the CKD condition

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  • Buffers 40% more acid than 650 mg sodium bicarbonate
  • Contains less sodium per milliequivalent of buffer
  • Is an enteric coated tablet that:
    1. Is easy to swallow
    2. Will not neutralize the stomach and cause bloating
    3. Maximizes delivery of buffer to the blood stream

Frequently Asked Questions

To buffer (or neutralize) an acidic solution, an alkali (or base) is added to the solution.  This is the same concept for managing acid imbalance in the body.  If there is too much acid, either reduce acid intake through dietary management or take an alkali to neutralize the acid load – or both.  RenaCarb is an alkali to manage acid imbalance or metabolic acidosis.
Compared to generic sodium bicarbonate tablets, RenaCarb is an enteric coated tablet which prevents it from dissolving in the stomach and causing bloating or GI distress.  It is an elegant, easy to swallow tablet.  RenaCarb is not a chalky tablet or a hard to swallow capsule.  RenaCarb delivers 40% more buffer and 25% less sodium than 650 mg sodium bicarbonate.
Bicarbonate is a compound that the body produces, recovers or absorbs to counteract ones daily acid load. The buffering capacity of an oral alkali (like sodium bicarbonate) is measured in units called mEq (milliequivalent) of bicarbonate. The more mEq of bicarbonate an alkali contains, the more buffer it delivers to the body. RenaCarb’s unique formulation contains 25% less sodium than 650 mg of sodium bicarbonate (7.7 mEq of bicarbonate), yet delivers 40% more buffer (10.8 mEq).

Enteric coating prevents tablets from dissolving in the stomach. By passing through the stomach and into the small intestine where the tablet is dissolved, patients no longer experience bloating and other GI side effects. This helps to improve patient compliance.

Dosing schedule

As directed by your health care provider.

Ingredients: 470 mg sodium bicarbonate, 260 mg magnesium carbonate, microcrystalline cellulose, magnesium stearate, hydroxypropyl methyl cellulose, mica/titanium dioxide, polyethylene glycol, FD&C red #40, FD&C blue #2.

RenaCarb is a medical food formulated to be administered under the supervision of a physician in accordance with FDA regulations.


30 years

Helping patients