If you read my blogs, you probably know I have been diagnosed with with Stage 4 CKD about 2 years ago. One of my prescriptions is 650 mg of sodium Bicarbonate daily.
Sodium bicarbonate (baking soda in medical form) is prescribed in chronic kidney disease (CKD) to help correct a problem called metabolic acidosis.
Here’s why:
Healthy kidneys normally keep the body’s acid–base balance in check by excreting acid and reabsorbing bicarbonate.
In CKD, especially stage 4, the kidneys lose this ability, causing acid to build up in the blood (metabolic acidosis).
Metabolic acidosis can:
Weaken bones by leaching out calcium and phosphorus.
Cause muscle wasting.
Worsen progression of kidney disease.
Increase fatigue and shortness of breath.
Sodium bicarbonate works by supplying extra bicarbonate (a base) to neutralize excess acid, helping restore a safer pH balance in your blood.
Benefits supported by research:
May slow CKD progression.
Helps protect bones and muscles.
Improves appetite and energy in some patients.
Cautions:
Because it contains sodium, it can increase blood pressure or cause fluid retention, so your doctor will watch your blood pressure, weight, and labs carefully.
Dose adjustments are common based on blood bicarbonate levels.
👉 In short: My doctor's prescription of sodium bicarbonate neutralize acid buildup in my kidneys. This helps protect my body and may slow down my CKD.
Here's a diet plan ( as recommended by my renal dietician) that can work hand-in-hand with my sodium bicarbonate therapy. In CKD, the goal is to lower dietary acid production (often called “net acid load”).
Here are some food categories and examples that can help reduce or add Acid Load:
🌱 Foods that reduce acid load
These foods are generally alkaline-producing in the body:
Fruits: apples, pears, peaches, berries, grapes, pineapple, watermelon, cherries.
Vegetables: leafy greens (spinach, kale, lettuce), cucumbers, cauliflower, bell peppers, zucchini.
Tubers: sweet potatoes, potatoes (limit portion if watching potassium).
Herbs and spices: parsley, cilantro, basil, cinnamon, turmeric.
⚖️ Foods that increase acid load (best to limit)
These are more acid-producing:
Red meats and processed meats.
Cheese and other dairy high in protein.
Eggs (especially yolks).
Processed grains (white bread, pasta).
Sodas/cola drinks (contain phosphoric acid).
🥗 Practical tips from My Nephrologist:
Aim for 2–3 servings of fruits/vegetables per meal, if your potassium is under control.
If you have high potassium levels, your kidney doctor or dietitian may guide you to lower-potassium fruits (apples, berries, grapes) and vegetables (cauliflower, zucchini, cabbage).
Plant-forward meals (more vegetables, less animal protein) tend to generate less acid.
Stay hydrated as advised by your nephrologist.
✅ Bottom line: A plant-rich, low-meat diet complements sodium bicarbonate by naturally lowering the acid burden on your body, which may help preserve kidney function and protect bones and muscles.
:✅ Daily Highlights:
Plenty of fruits and vegetables (alkaline-forming).
Lean protein in small portions (limits acid load).
Low sodium, low phosphorus, controlled potassium.
Complements sodium bicarbonate therapy by further reducing acid burden.
Here's a 7-day rotating CKD-friendly meal plan designed for Stage 4 CKD, taking sodium bicarbonate, focusing on lowering acid load while controlling protein, potassium, phosphorus, and sodium.
⚠️ Important: This is a general guide. Individual needs vary a lot in Stage 4 CKD — especially potassium, phosphorus, protein, and fluid — so please review this with your nephrologist or renal dietitian before following strictly.
🥗 7-Day CKD Meal Plan (Stage 4, Low Acid Load)
🌅 Day 1
Breakfast: Oatmeal with blueberries + apple slices, 1 slice white toast
Lunch: Grilled chicken (3 oz), white rice, cucumber & cabbage salad
Snack: Rice cakes with apple slices
Dinner: Baked cod (3 oz), zucchini sauté, mashed potatoes (½ cup, leached if needed)
Evening Snack: Unsalted popcorn + grapes
🌅 Day 2
Breakfast: Cream of wheat with strawberries (¼ cup), slice of white bread with unsalted margarine
Lunch: Turkey sandwich (2 oz lean turkey on white bread, lettuce, cucumber), side of cauliflower
Snack: Pear slices + rice crackers
Dinner: Grilled tilapia (3 oz), steamed carrots (½ cup), couscous (½ cup)
Evening Snack: Unsalted pretzels + apple slice
🌅 Day 3
Breakfast: Rice porridge with cinnamon + diced apple
Lunch: Chicken stir-fry (2 oz chicken, cabbage, zucchini, onion) over white rice
Snack: Unsalted graham crackers + blueberries
Dinner: Baked salmon (3 oz), roasted cauliflower, white pasta with olive oil & herbs
Evening Snack: Air-popped popcorn + grapes
🌅 Day 4
Breakfast: Pancakes (small, made with white flour), topped with strawberries, drizzle of maple syrup
Lunch: Turkey and cucumber wrap (tortilla, 2 oz turkey, lettuce, cucumber), side of cabbage salad
Snack: Apple slices with unsalted rice cakes
Dinner: Baked chicken thigh (3 oz, skinless), zucchini sauté, mashed potatoes (leached)
Evening Snack: Unsalted crackers + blueberries
🌅 Day 5
Breakfast: White toast (2 slices) with unsalted margarine, pear slices, herbal tea
Lunch: Grilled white fish (3 oz), couscous, cucumber salad
Snack: Rice cakes with cream cheese (1 Tbsp)
Dinner: Baked turkey meatballs (2–3 small), steamed cauliflower, white pasta with olive oil
Evening Snack: Unsalted pretzels + apple slice
🌅 Day 6
Breakfast: Cream of rice cereal with blueberries + sprinkle of cinnamon
Lunch: Chicken salad (2 oz chicken, lettuce, cucumber, vinegar dressing) with white roll
Snack: Graham crackers + pear slices
Dinner: Broiled cod (3 oz), roasted zucchini, mashed potatoes (½ cup, leached)
Evening Snack: Air-popped popcorn + grapes
🌅 Day 7
Breakfast: Small waffle with strawberries + drizzle of honey, white toast with margarine
Lunch: Turkey sandwich (2 oz turkey, lettuce, cucumber) with steamed carrots
Snack: Rice crackers + apple slices
Dinner: Baked tilapia (3 oz), sautéed cabbage, white rice (½ cup)
Evening Snack: Unsalted popcorn + blueberries
✅ Meal Plan Highlights
Protein: Lean meats/fish in small portions (2–3 oz per meal).
Alkaline foods: Cabbage, cauliflower, zucchini, cucumber, berries, apples, pears.
Controlled potassium: Fruits/veggies chosen to be lower in potassium (swap per lab results).
Low phosphorus & sodium: Avoids processed meats, cheese, dark sodas.
Supports sodium bicarbonate therapy: Plant-forward, less acid load.
Personal Note: Because I do not prepare my meals residing here at THD, I can not exactly follow in detail the 7-day meal plan. However, I try to follow the Meal Plan Highlights listed above, along with my sodium bicarbonate therapy.
Good Bye to my two favorite Pinoy Dishes: Kare Kare and Dinugu-an.
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