title: Dietary origin of retained H+ in infants with acquired monosaccharide intolerance.
abstract: Net external acid balance was studied in 12 malnourished infants with chronic diarrhea (some of whom had acquired monosaccharide intolerance). When the infants achieved an adequate energy intake from a formula that contained either glucose or glucose polymers, seven developed metabolic acidosis and five remained free of acidosis. During the study, the acidotic infants produced a significant excess of acid (3.7 +/- 2 vs. 0.5 +/- 2 mEq/kg/day, p less than 0.005). The amount they excreted in urine (2.9 +/- 2 mEq/kg/day), however, was similar to that excreted by nonacidotic infants (2.7 +/- 2 mEq/kg/day) and indicated renal inability to reduce the excess acid load. The net effect was hydrogen ion (H+) retention (+0.8 +/- 0.8 vs. -2.2 +/- 0.8 mEq/kg/day, p less than 0.001). Good correlation existed between the net acid balance and the acid-base measurement in the blood. We speculate that (a) the increased acid load was a consequence of colonic bacterial production of volatile fatty acids from carbohydrate malabsorbed from the small bowel and (b) the renal incapacity to excrete H+ probably was secondary to potassium and phosphate depletion.
authors.affiliation: USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
authors.forename: F R
authors.initials: FR
authors.lastname: Carrazza
authors.forename: M Z
authors.initials: MZ
authors.lastname: Carrazza
authors.forename: V N
authors.initials: VN
authors.lastname: Nichols
authors.forename: B L
authors.initials: BL
authors.lastname: Nichols
mesh_terms: D000138:Acidosis / Q000378:metabolism*; D003968:Diarrhea, Infantile / Q000209:etiology; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000378:metabolism; D008286:Malabsorption Syndromes / Q000378:metabolism; D009005:Monosaccharides / Q000009:adverse effects*
chemical_list: D004040:Dietary Carbohydrates; D009005:Monosaccharides