PMID: 7708Apr 1, 1976

Lithium-induced impairment of urine acidification

Kidney International
J M RoscoeB J Stinebaugh


The purpose of this study was to clarify the means by which lithium induced a disorder of urine acidification. Rats infused with hydrochloric acid (1 mEq/kg) developed acute metabolic acidosis (blood Ph = 7.32; bicarbonate, 18 mEq/liter) with a urine pH of approximately 5.85. The addition of lithium chloride (4 mEq/kg i.p) caused an increase in the urine pH (6.38) and a further decrease in blood bicarbonate (11.0 mEq/liter). During bicarbonate loading, lithium caused the urine PCO2 to fall significantly (urine minus blood PCO2 decreased from 25.3 +/-2.8 To 14.4 +/- 2.3 mm Hg) These changes were not seen following equimolar i.p. administration of sodium chloride. Similarly, lithium administration depressed bicarbonate reabsorption by 11.1% (from 30.6 to 27.2muEq/ml of GFR) during alkali infusion, while saline caused only a 5% decrease (30.0 to 28.5muEq/ml of GFR). The combination of an increase in urine PCO2 in alkaline urine indicates that lithium produced a defect in distal nephron hydrogen ion secretion. The fall in bicarbonate reabsorption following lithium administration oculd be due to a mild hydrogen ion secretory defect located in the proximal tubule or a severe defect in the distal nephron.


May 1, 1972·The Journal of Clinical Investigation·I SingerJ B Puschett
Mar 1, 1973·Kidney International·I Singer, E A Franko
Aug 2, 1973·The New England Journal of Medicine·I Singer, D Rotenberg
Mar 1, 1974·The Journal of Clinical Investigation·M L HalperinB J Stinebaugh
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Mar 12, 2009·Pflügers Archiv : European journal of physiology·Carsten A WagnerNilufar Mohebbi
Feb 1, 1996·Disease-a-month : DM·M E Laski, N A Kurtzman
Jul 1, 1976·The Journal of Clinical Investigation·R A GiammarcoB J Stinebaugh
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Jul 11, 2006·American Journal of Physiology. Renal Physiology·Joris H RobbenPeter M T Deen
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Related Concepts

Acid-Base Imbalance
Metabolic Acidosis
Renal Tubular Acidosis, Type II
Carbonic Acid Ions
Glomerular Filtration Rate
Hydrogen-Ion Concentration
Kidney Tubules, Proximal
Sodium Chloride, (24)NaCl

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