Renal response to metabolic alkalosis induced by isovolemic hemofiltration in the dog.
We describe a new model of chloride-depletion alkalosis (CDMA), in which the method of induction of alkalosis does not itself cause a direct alteration in sodium and fluid balance. We have used this model, which is based on hemofiltration techniques in the dog, to study the immediate response of the kidney to the induction of CDMA. Normal dogs maintained with a NaCl-free diet for several days underwent hemofiltration of 50 ml/kg over a 35 minute period. The hemofiltrate was replaced ml for ml with a solution containing sodium and potassium in the same concentrations as found in each animal's plasma water. In control animals, the replacement solution contained chloride and bicarbonate in the same ratio as in the plasma; in the experimental (CDMA) animals the replacement solution contained bicarbonate as the only anion. In the control group, the procedure of hemofiltration coupled with isovolemic replacement caused no appreciable changes in plasma composition, urinary excretion rates, GFR, or tubular handling of bicarbonate. In the CDMA group, 106 +/- 8.4 mEq of chloride were removed in exchange for bicarbonate. A marked metabolic alkalosis resulted, plasma bicarbonate concentration increasing from 21.9 +/- 0.6 to 33.3 +/- 0.6 mEq/liter. The hemofiltration procedure itself, by design, did not alter sodium or fluid balance. Nevertheless, cumulative urinary sodium excretion increased over 2.5 hours by 23.0 +/- 6.4 mEq. A natriuresis of this magnitude is equivalent to a loss of ECF volume of approximately 200 ml. GFR did not change significantly. The rate of tubular reabsorption of bicarbonate increased significantly from 1209 +/- 82 to 1559 +/- 148 mu Eq/min in CDMA animals.(ABSTRACT TRUNCATED AT 250 WORDS)
Borkan
S
S
Department of Medicine, Michael Reese Hospital and Medical Center, University of Chicago, Illinois.
Northrup
T E
TE
Cohen
J J
JJ
Garella
S
S
D000471:Alkalosis / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D000818:Animals; D001639:Bicarbonates / Q000097:blood / Q000378:metabolism; D001810:Blood Volume; D002712:Chlorides / Q000378:metabolism; D004285:Dogs; D005110:Extracellular Space / Q000502:physiology; D005260:Female; D005919:Glomerular Filtration Rate; D006440:Hemofiltration; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000503:physiopathology*; D007684:Kidney Tubules / Q000378:metabolism; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000652:urine
D001639:Bicarbonates; D002712:Chlorides; D012964:Sodium; D011188:Potassium