A major clinical trial published by the New England Journal of Medicine has found that sodium bicarbonate offers no advantage over a placebo in protecting the kidneys of critically ill patients with a dangerous build-up of acid in the blood.
The SODa-BIC trial looked at adults in intensive care units (ICUs) who had metabolic acidosis — a condition where the blood becomes too acidic — and who were already receiving vasopressors, the drugs used to raise dangerously low blood pressure. Researchers measured whether sodium bicarbonate, an alkaline solution given intravenously to counteract excess acid, could reduce the risk of major adverse kidney events within 30 days. It did not.
The results are notable because sodium bicarbonate has long been used in ICUs on the assumption that correcting blood acidity might protect the kidneys and improve survival. This trial puts that assumption under direct scrutiny.
The New England Journal of Medicine, which published the full SODa-BIC trial results alongside a Research Summary, is one of the most widely read peer-reviewed medical journals in the world. Findings published there carry significant weight in shaping clinical practice.
At the same time, the trial focused specifically on critically ill adults — patients already in a serious condition requiring vasopressor support. That narrow focus means the results apply to a particular group of ICU patients, not to all uses of sodium bicarbonate in medicine.
Source: @NEJM