Sodium-dependent urinary acidification in patients with aldosterone deficiency and in adrenalectomized rats: effect of furosemide

Metabolism: Clinical and Experimental
Daniel Batlle

Abstract

Urinary acidification during metabolic acidosis and in response to stimulation of sodium-dependent hydrogen ion secretion using furosemide administration was evaluated in 12 patients with hyperkalemic hyperchloremic metabolic acidosis associated with mild chronic renal insufficiency and aldosterone deficiency. During spontaneous metabolic acidosis, the urine of all patients was acidic (pH less than 5.5), but ammonium excretion was markedly reduced (6.6 +/- 1.3 mu Eq/min) comprising only about 20% of net acid excretion (30.5 +/- 5.7 mu Eq/min). Furosemide (80 mg orally) resulted in a further fall in urine pH (from 5.29 +/- 0.06 to 4.97 +/- 0.09, P less than 0.02) and a significant increase in net acid excretion (from 30 +/- 5.8 to 38 +/- 5.1 mu Eq/min, P less than 0.02) while plasma aldosterone did not change (from 9.8 +/- 1.7 to 9.7 +/- 1.6 micrograms/dL). To investigate whether the acute stimulatory effect of furosemide on distal acidification requires some degree of mineralocorticoid activity, studies were conducted in adrenalectomized rats. The fall in urine pH and the increase in net acid excretion elicited by furosemide in adrenalectomized rats were comparable to those observed in adrenal-intact animals (5.37 +/- 0.10 v 5....Continue Reading

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Citations

Sep 22, 2005·Proceedings of the National Academy of Sciences of the United States of America·Karin E FinbergRichard P Lifton
Nov 8, 2008·The Journal of Biological Chemistry·Daniel M Collier, Peter M Snyder
Feb 6, 2007·Seminars in Nephrology·Daniel BatlleNeil Kurtzman
Jan 15, 1987·The New England Journal of Medicine·D C BatlleW Schlueter
Mar 10, 1988·The New England Journal of Medicine·D C BatlleR Gupta
Oct 1, 1991·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M M SalemD C Batlle
Feb 28, 2018·Journal of the American Society of Nephrology : JASN·Autumn N HarrisI David Weiner
Dec 17, 2014·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Qiao-Ling SunYi-Pu Chen
Jun 1, 1996·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·D Batlle, G Flores

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