Sodium bicarbonate has been shown to slow the progression of chronic kidney disease (CKD) in patients with a metabolic acidosis. A metabolic acidosis is defined as a serum bicarbonate level that is less than 22 milliequivalents per liter (mEq/L) and is not related to lung disease. The goal of treatment is to keep the serum bicarbonate level greater than 22, so the dose depends on the degree of acidosis, body size and degree of CKD. One teaspoon of baking soda (sodium bicarbonate) is roughly 7 mEq. Your son’s physician should help guide the dosing based on measurement of blood levels and response to treatment.