A randomized Vienna trial found that pushing serum bicarbonate toward near-normal targets did not slow kidney function decline in advanced chronic kidney disease compared with a more conservative target. The results directly challenge the rationale for aggressive correction strategies in late-stage patients. For clinicians and guideline developers, the study’s implication is straightforward: higher bicarbonate targets may not translate into renal preservation benefits strong enough to justify the added monitoring and potential risks tied to more intensive biochemical normalization. The trial also reinforces a broader evidence requirement for biochemical interventions in CKD—especially when endpoints center on hard measures like filtration decline rather than intermediate lab improvements.