Biomarkers · Electrolytes & Minerals

Serum Bicarbonate

Higher values go with lower risk of death. Not measured in our NHANES panel. The curve is drawn from the published study (source below).

Serum Bicarbonate and risk of death

Published curve higher than the NHANES fitNHANES fit higher

Risk of death relative to the curve's reference value, drawn from the published study (source below).

Published risk of death1.46×lowest vs highest quartile of serum bicarbonate (95% CI 1.07–2.00) · 31,590 Korean adults undergoing health screening 2001-2010 with eGFR >=60

Serum Bicarbonate by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table

Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (mEq/L), from the survey named in the row. Not a reference range or a target.
Sex	Age	5th	25th	Median	75th	95th	n	Cycle / source
All	20-39	21.0	24.0	26.0	27.0	29.0	1,429	NHANES 2017-2018
All	40-59	22.0	24.0	26.0	27.0	29.0	1,548	NHANES 2017-2018
All	60+	22.0	24.0	26.0	28.0	30.0	1,890	NHANES 2017-2018
All	all	22.0	24.0	26.0	27.0	30.0	4,867	NHANES 2017-2018
Men	20-39	22.0	25.0	26.0	28.0	30.0	684	NHANES 2017-2018
Men	40-59	22.0	24.0	26.0	27.0	29.0	723	NHANES 2017-2018
Men	60+	21.0	24.0	26.0	28.0	30.0	958	NHANES 2017-2018
Men	all	22.0	24.0	26.0	28.0	30.0	2,365	NHANES 2017-2018
Women	20-39	21.0	23.0	25.0	26.0	28.0	745	NHANES 2017-2018
Women	40-59	21.0	24.0	26.0	27.0	29.0	825	NHANES 2017-2018
Women	60+	22.0	24.0	26.0	28.0	30.0	932	NHANES 2017-2018
Women	all	21.0	24.0	25.0	27.0	29.0	2,502	NHANES 2017-2018

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in Serum Bicarbonate, study by study

4 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Intervention	Reported effect	Evidence	Source
clinical	Intraoperative balanced electrolyte solutions instead of 0.9% saline during kidney transplantation	Serum bicarbonate higher by 3.02 mEq/L (95% CI 2.00-4.05) with balanced solutions vs saline (3 studies, 215 participants)	meta-analysis	Wan S, Roberts MA, Mount P. Normal saline versus lower-chloride solutions for…
clinical	Bicarbonate-buffered instead of lactate-buffered solution for acute peritoneal dialysis in shocked patients with AKI	Serum bicarbonate 5.00 mmol/L higher (95% CI 3.26-6.74) with bicarbonate vs lactate solution in shock patients	systematic review	Bai ZG, Yang K, Tian JH, et al. Bicarbonate versus lactate solutions for acute…
supplement	Single oral dose of sodium bicarbonate 0.3 g/kg body mass taken before exercise, timed to individual peak alkalosis	Blood HCO3- increased by 5.6 +/- 0.2 mmol/L vs placebo before exercise	RCT	Shannon ES, Regnier A, Dobson B, et al. The effect of sodium bicarbonate…
supplement	Sodium bicarbonate 150 mg/kg before and 150 mg/kg during a 3-h simulated cycling race	Blood [HCO3-] 31.5 vs 24.4 mmol/L with placebo prior to the end-of-race 90-s sprint (p<0.001)	RCT	Dalle S, Koppo K, Hespel P. Sodium bicarbonate improves sprint performance in…

Things that worsen it

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Condition or exposure	Reported effect	Evidence	Source
pharmacologic	Sevelamer instead of calcium-based phosphate binders for hyperphosphataemia in adult dialysis patients	Pooled on-treatment decrease in serum bicarbonate 2.8 mmol/l greater with sevelamer (interval 2.2 to 3.5)	meta-analysis	Tonelli M, Wiebe N, Culleton B, et al. Systematic review of the clinical…

Sources

Risk curve: Park M 2015 (PMID 25762414): all-cause HR 1.46 (1.068-1.995) lowest vs highest quartile of serum bicarbonate. Scaled to US values (NHANES).
Park M, Jung SJ, Yoon S, Yun JM, Yoon HJ. Association between the markers of metabolic acid load and higher all-cause and cardiovascular mortality in a general population with preserved renal function. Hypertens Res. 2015;38(6):433-438.

Map Serum Bicarbonate against another biomarker.

Map Serum Bicarbonate against another marker