A 66-year-old woman with CKD G4 has fatigue and worsening breathlessness. eGFR is 24 mL/min/1.73 m², bicarbonate 16 mmol/L and chloride 113 mmol/L.

Question

A 66-year-old woman with CKD G4 has fatigue and worsening breathlessness. eGFR is 24 mL/min/1.73 m², bicarbonate 16 mmol/L and chloride 113 mmol/L. Venous pH is 7.30 and potassium is 5.1 mmol/L; she is euvolaemic. What is the most appropriate management?

Accepted Answer

Start oral sodium bicarbonate and monitor volume status

Answer

Begin urgent haemodialysis solely for bicarbonate 16

Answer

Increase dietary protein substantially

Answer

Give intravenous calcium gluconate

Answer

Start acetazolamide

Metabolic acidosis in CKD — ESENeph MCQ

A 66-year-old woman with CKD G4 has fatigue and worsening breathlessness. eGFR is 24 mL/min/1.73 m², bicarbonate 16 mmol/L and chloride 113 mmol/L. Venous pH is 7.30 and potassium is 5.1 mmol/L; she is euvolaemic. What is the most appropriate management?