Administering sodium bicarbonate in crush injury management is primarily intended to prevent kidney injury by alkalinizing urine. Which choice best represents this rationale?

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In crush injuries, muscle breakdown releases myoglobin that’s filtered by the kidneys. In acidic urine, myoglobin can precipitate and form obstructive casts, causing kidney injury. Sodium bicarbonate raises urine pH, making myoglobin more soluble and reducing its tendency to form casts in the tubules, thereby protecting renal function. That’s why the rationale centers on alkalinizing urine to prevent myoglobin-induced nephropathy. While bicarbonate can help with acidosis, the primary protective goal here is preventing kidney injury from myoglobin.