Alkali therapy versus sodium chloride supplement in low birthweight infants with incipient late metabolic acidosis.
Two hundred and eighty-two patients with birthweights below 2.0 kg were routinely screened for spontaneous development of maximum renal acid stimulation (urine-pH < 5.4). Sixty episodes in 53 patients of incipient late metabolic acidosis (urine pH < 5.4 on 2 consecutive days) were randomly allocated to oral therapy with 2 mmol/kg/day of either NaHCO3 or NaCl for 7 days. All 27 patients on NaHCO3 therapy, but only 15 from 26 patients on NaCl therapy, showed an increase in urine pH values, combined with a relatively high gain in body weight and a tendency to increased N-assimilation. Eleven patients on NaCl therapy showed persistent maximal renal acid stimulation on all 7 days with possibly lower weight gain and no clear change in N-assimilation. Thus, in patients with incipient late metabolic acidosis, NaCl therapy is not as beneficial as NaHCO3 therapy.
Kalhoff
H
H
Pediatric Clinic, Dortmund and Research Institute of Child Nutrition, Germany.
Diekmann
L
L
Kunz
C
C
Stock
G J
GJ
Manz
F
F
D000141:Acidosis, Renal Tubular / Q000175:diagnosis / Q000188:drug therapy* / Q000652:urine; D001835:Body Weight; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000652:urine; D007236:Infant, Small for Gestational Age; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use*
D012965:Sodium Chloride; D017693:Sodium Bicarbonate