Bozikas A, et al. - Researchers investigated the acid-base status with dialysis bath of higher bicarbonate (HC03⁻) concentration or standard HC03⁻ bath plus oral HC03⁻ supplementation. According to the pre-dialysis acid-base status both before the first and the second session of the week dialyzed against standard base dialysate of 35 mmol/L, they evaluated a total of 60 stable HD patients (pts). Dialysis against bath of increased HC03⁻ levels (37 mmol/L) was assigned to those who presented predialysis HC03⁻ <22 mmol/L (25 pts) for 2 weeks (period A) and subsequently these patients were assigned to dialysis with the standard dialysate bath plus daily oral sodium bicarbonate at a dose of 5 g/day for 2 weeks (period B). Outcomes revealed a considerable degree of pre-dialysis acidemia in correlation with the reception of conventional HC03⁻ concentrations of 35 mmol/L. More prominent post-dialysis alkalemia was noted with increasing HC03⁻ in bath, however, it is not identified to be sufficient to maintain acid-base status during the interdialytic period. At a dose of 5 g/day (divided in three daily doses), oral bicarbonate supplement led to a more balanced acid-base status, avoiding post-dialysis alkalemia.