Sodium bicarbonate for older patients with chronic kidney disease and mild acidosis - is it value for money?

Acidosis is common in chronic kidney disease

Chronic kidney disease (CKD) is a health condition where the kidneys are not working as well as they should. It is more common in older people. It affects about 2% of those aged 70 years and above. The kidneys remove wastes, excessive acids, salt, water and minerals from our blood and get rid of them through urine. Healthy kidneys are important for healthy blood and for our health in general.

As kidney function gets worse,…

Governments use social distancing measures to try to control the COVID-19 pandemic. Countries have used different policies. These policies, often lockdowns, aim to slow the spread of the disease. They also prevent hospitals from running out of capacity.

During the first stages of the pandemic, governments put national lockdowns in place. Later in the pandemic, lockdowns focused on more local areas. It is expected lockdowns will continue to happen until a treatment or vaccine for COVID-19 is available.

How well local lockdowns work depends on the public following the rules.…

It is estimated that as many as between 3 million and 6 million people in the UK experience some degree of urinary incontinence. There are several types of incontinence. Stress incontinence is one of the main trypes. It is caused by sphincter weakness and occurs when there is pressure on the abdomen created by sneezing, coughing, lifting, or straining. The second common type is urge incontinence, caused by bladder abnormalities leading to an irresistible urge to pass urine. The third main type is mixed incontinence which is a combination of stress and urge.

Treatments

Urinary…

Doctors' Risk Attitude

Risk attitude is known to vary substantially across individuals. Some individuals are very risk averse and tend to make safe choices (e.g. investing in a bond) whilst others are more risk seeking and are more comfortable with risky choices (e.g. investing in the stock market). Clinical decisions generally involve risks and the risk attitude of the doctor (and the patient) is therefore important. For example, women with a BRCA gene mutation are believed to have a higher risk of breast cancer. Treatment options include frequent cancer screening which is less invasive but associated with a higher…

Minimum unit pricing (MUP) for alcohol was introduced in Scotland in May 2018 as part of the Scottish Government’s strategy to reduce the health and social harms associated with alcohol misuse. The graph below shows that for a long time Scotland has had the highest alcohol-specific death rate in the UK. It also shows that this rate had been falling up to 2012 but progress has stalled.

Source: Office for National Statistics (2019). Alcohol-specific deaths in UK: registered in 2018. 

There is…