I have seen something about sodium bicarbonate helping PKD before. I'm not sure how that works - but I feel like maybe it's because it's sodium in a different form it doesn't affect us the same? But I think you should ask your doctor about that because he obviously has a reason for doing that. And you should pay close attention to if you feel any different - worse or better - and tell your doctor. Keep us posted please!

I am on sodium bicarbonate too recently. I believe it is to help counteract the nausea and stomach acid I was having. Hope this helps.
Hope things go well for you.
Patricia.

I was put on sodium bicarb when in renal failure and I'm not sure what it does but I definitely felt better.
I asked my doctor and he said to cut back on other sodium to compensate for what I was getting in the bicarb.
I got an explanation at the time but I never fully understood it, I just know it worked.

Polykid,
At this point in time, let your doctor do the math when it comes to the sodium levels and you just follow his/her direction when it comes to medications and diet. Be sure to ask lots of questions, because you're going to have a ton of them. Bring a notebook with you; the same one that you write down all your questions in as well. You're in a transition period and it's an awkward one, where doctors order things (like sodium bicarbonate) that seem to be contrary to what you've been told for the past 10 or so years!

As Patricia said the sodium bicard does help with nausea and stomach acid; it will also help keep your body's acid/base level in balance (your doctor will monitor this by watching your labs, in particular your CO2 level for this one).

The National Kidney Foundation has a new package that helps patients make a choices about dialysis and transplants, focused for patients who reach stage 4 kidney failure. You can order you own from http://www.kidney.org/professionals/KLS/YTYC.cfm. They also have some other interesting information and links on their site you may find helpful.

I hope this helps!
Gentle hugs,
Ruth

Thanks guys! That makes me feel better. I know I need to ask questions more but its hard since I don't always see the kidney doctor everytime I have a doctor appointment. Like I mentioned before I go to a free clinic and I only see him when he decides to go there. So sometimes I am seeing a general doctor. Thats why I ask for help here. So thanks again.

Part of my scientific training has been in aqueous chemistry. I would not take sodium bicarbonate, because any sodium is sodium and this is would give you just as much as eating salt. On the other hand calcium carbonate gives the same amount of acid neutralization as sodium bicarbonate. TUMS is basically calcium carbonate (look at the ingredients) with a little sugar added for flavor.

Okay I ran the numbers. There is about 1850 mg of sodium in a teaspoon of table salt and about 1280 mg of sodium in a teaspoon of sodium bicarbonate. This assumes a teaspoon is 1/6th of an ounce.

Ward,
Part of the issue at this point in kidney function (just prior to dialysis) is the kidneys can't effectively process the excess calcium, thus sodium bicarbonate is used (the excess calcium can cause renal osteodystrophy, which is irreversible bone damage). It's a very careful balance and once patients reach this point, it takes advanced biochemistry at its finest to maximize the residual kidney function while keeping electrolytes in balance as much as possible. Things are changing and usually somewhat quickly (and it's often different for each patient; we are unique from beginning to end) and it doesn't always make sense in terms of what we've been told for the last 20 or so years, but it really does work.

Polykid,
I'm confident your general practitioners are consulting with the nephrologist even though you're not necessarily seeing him each and every visit. What state do you live in? I ask because some states have special kidney programs (e.g. Maryland) for their residents, regardless of ability to pay (and especially for those with no insurance. You may be living in one of those states and not be aware of it. Please check your state government services online and see what you find; you may be pleasantly surprised.

Hope this helps,
Ruth

Yes, it sounds like in that case you may want to avoid excess calcium. Everything in moderation.