Kittiskulnam P, Srijaruneruang S, Chulakadabba A, et al. - In this randomized, controlled study, researchers focused on the influences of raised serum bicarbonate levels on muscle parameters, nutrition, and renal function in pre-dialysis chronic kidney disease (CKD) patients. They used protocol-based titration of dosage adjustment, to randomize CKD stage 3–4 patients with serum HCO₃^– < 22 mEq/L to either receive oral sodium bicarbonate with high target bicarbonate level of 25 ± 1 or standard level of 22 ± 1 mEq/L as control group. At the end of the study, there were 42 patients (n = 21 per group). Findings revealed better muscle mass preservation in relation to bicarbonate supplementation to achieve the serum level ∼24 mEq/L in patients with pre-dialysis CKD. A longer duration of study may be needed in order to determine the influence of alkaline therapy on renal function.