NaHCO(3) and KHCO(3) ingestion rapidly increases renal electrolyte excretion in humans.
This paper describes and quantifies acute responses of the kidneys in correcting plasma volume, acid-base, and ion disturbances resulting from NaHCO(3) and KHCO(3) ingestion. Renal excretion of ions and water was studied in five men after ingestion of 3.57 mmol/kg body mass of sodium bicarbonate (NaHCO(3)) and, in a separate trial, potassium bicarbonate (KHCO(3)). Subjects had a Foley catheter inserted into the bladder and indwelling catheters placed into an antecubital vein and a brachial artery. Blood and urine were sampled in the 30-min period before, the 60-min period during, and the 210-min period after ingestion of the solutions. NaHCO(3) ingestion resulted in a rapid, transient diuresis and natriuresis. Cumulative urine output was 44 +/- 11% of ingested volume, resulting in a 555 +/- 119 ml increase in total body water at the end of the experiment. The cumulative increase (above basal levels) in renal Na(+) excretion accounted for 24 +/- 2% of ingested Na(+). In the KHCO(3) trial, arterial plasma K(+) concentration rapidly increased from 4.25 +/- 0.10 to a peak of 7.17 +/- 0.13 meq/l 140 min after the beginning of ingestion. This increase resulted in a pronounced, transient diuresis, with cumulative urine output at 270 min similar to the volume ingested, natriuresis, and a pronounced kaliuresis that was maintained until the end of the experiment. Cumulative (above basal) renal K(+) excretion at 270 min accounted for 26 +/- 5% of ingested K(+). The kidneys were important in mediating rapid corrections of substantial portions of the fluid and electrolyte disturbances resulting from ingestion of KHCO(3) and NaHCO(3) solutions.
Lindinger
M I
MI
Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph N1G 2W1, Canada L8N 3Z5. mlindinger.ns@aps.uoguelph.ca
Franklin
T W
TW
Lands
L C
LC
Pedersen
P K
PK
Welsh
D G
DG
Heigenhauser
G J
GJ
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000143:Acids / Q000097:blood / Q000652:urine; D000284:Administration, Oral; D000328:Adult; D000450:Aldosterone / Q000097:blood; D000468:Alkalies / Q000097:blood; D001639:Bicarbonates / Q000008:administration & dosage / Q000494:pharmacology*; D002118:Calcium / Q000652:urine; D004573:Electrolytes / Q000652:urine; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D007773:Lactates / Q000652:urine; D008297:Male; D011188:Potassium / Q000652:urine; D017680:Potassium Compounds / Q000008:administration & dosage / Q000494:pharmacology*; D000644:Quaternary Ammonium Compounds / Q000652:urine; D012964:Sodium / Q000652:urine; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000494:pharmacology*; D014554:Urination / Q000187:drug effects; D014563:Urodynamics / Q000187:drug effects; D014882:Water-Electrolyte Balance / Q000187:drug effects
D000143:Acids; D000468:Alkalies; D001639:Bicarbonates; D004573:Electrolytes; D007773:Lactates; D017680:Potassium Compounds; D000644:Quaternary Ammonium Compounds; D000450:Aldosterone; D017693:Sodium Bicarbonate; D012964:Sodium; C026329:potassium bicarbonate; D011188:Potassium; D002118:Calcium