EFFECT OF MASSIVE SODIUM BICARBONATE INFUSION ON RENAL FUNCTION

Abstract

The effect of both mild and severe acute alkalosis, due to intravenous sodium bicarbonate infusion, on glomerular filtration rate, renal plasma flow, and sodium and potassium clearance was investigated on 12 anesthetized dogs. The maximum load used was over 50 grams of NaHCO3 administered intravenously in 4 hours, at a rate of 2.5 meq/minute. On a weight basis, in a 70-kg man, this would be equivalent to a load of 195 grams of NaHCO3 given at the rate of nearly 10 meq/minute. The plasma potassium fell from 3.8 meq/l. to 2.7 meq/l. and the plasma sodium increased from 144.4 to 170.8 meq/l. with maximum NaHCO3 loading. There was no apparent acute detrimental renal effect. No depression of GFR or RPF was seen in any series although the pH increased from 7.32 to 7.61. Similarly no significant effect was seen on blood pressure, hematocrit, filtration fraction, heart rate, or rectal temperature in any series. Urine flow and urine pH increased significantly with higher loading rates and concentrations.