Treatment of severe metabolic alkalosis with continuous renal replacement therapy: bicarbonate kinetic equations of clinical value.

The authors describe a kinetic modeling tool to safely regulate the osmotic changes that can occur when treating severe metabolic alkalosis and concurent hypernatremia.  The authors discuss disequilibrium syndrome and brain edema, a potential occurence when intermittant dialisis is used versus a longer, slower, and potentially more easily regulable therapy such as CRRT.