Affiliation:
1. Institut National de la Santé et de la Recherche Médicale, Unité de Recherche de Réanimation, Hôpital Claude Bernard, Paris, and Laboratoire de Physiologie, Université Paris VII, Hôpital Louis Mourier, Colombes, France
Abstract
1. K+ depletion of two kinds was induced in two groups of rats by selective dietary restriction for up to 5 weeks. Complete metabolic studies for H+, K+, Na+ and Cl− were carried out daily during weeks 1, 3 and 5.
2. In control rats of group A (receiving K+ with sodium chloride), plasma pH (7.47) and HCO−3(25 mmol/l), as well TA (titratable acid) —- HCO−3 and NH+4 urinary excretion rates, were stable, while balances were nil for K+ and slightly positive for Cl−. In K+-deprived rats of group A receiving sodium chloride, a progressive metabolic alkalosis developed (plasma pH reached 7.57 and HCO−3 35.8 mmol/l by 5 weeks), and TA - HCO−3 and NH+4 urinary excretion rates were not different from controls. Plasma K+ fell progressively from 4.20 to 2.20 mmol/l, with negative K+ balance. Balances for Na+ and H2O were highly positive and plasma renin activity and aldosterone decreased by week 5. Hypochloraemia developed with positive Cl− balance.
3. In control rats of group B (receiving K+ with neutral sodium phosphate), a slight metabolic alkalosis developed, and TA - HCO−3 excretion rate was increased compared with control rats of group A. Balances were slightly negative for K+ and Cl−. In K+-deprived rats of group B receiving neutral sodium phosphate, a profound metabolic alkalosis developed (plasma pH reached 7.60 and HCO−3 42.6 mmol/l by 5 weeks), and TA-HCO−3 and NH+4 excretion rates were at no time different from those of control rats of group B. Plasma K+ fell progressively from 4.25 to 2.30 mmol/l, and K+ balance was more negative than that in control rats of group B. Hypochloraemia developed with a negative Cl− balance.
4. In both K+-restricted groups, a linear negative correlation was observed between plasma HCO−3 (or pH) and plasma K+. These results suggest that metabolic alkalosis does occur in sustained selective K+-depletion in rats. Metabolic alkalosis could be generated essentially by net transfer of H+ from extracellular fluid (ECF) into cells, probably in exchange for K+ in the reverse direction. Metabolic alkalosis could be maintained by an increase in tubular reabsorption of filtered HCO−3, probably via an enhanced Na+/H+ exchange in the proximal tubule in sodium chloride-loaded rats, which may account for the ECF volume expansion with low plasma renin activity and aldosterone, and via an enhanced Cl−/HCO−3 exchange in distal nephron in sodium phosphate-loaded rats.
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