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J Appl Physiol 88: 540-550, 2000;
8750-7587/00 $5.00
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Vol. 88, Issue 2, 540-550, February 2000

NaHCO3 and KHCO3 ingestion rapidly increases renal electrolyte excretion in humans

Michael I. Lindinger1, Thomas W. Franklin1, Larry C. Lands2, Preben K. Pedersen3, Donald G. Welsh1, and George J. F. Heigenhauser2

1 Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph N1G 2W1; 2 Department of Medicine, McMaster University, Hamilton, Ontario, Canada L8N 3Z5; and 3 Department of Sports Science and Physical Education, University of Odense, DK 5230 Odense, Denmark

This paper describes and quantifies acute responses of the kidneys in correcting plasma volume, acid-base, and ion disturbances resulting from NaHCO3 and KHCO3 ingestion. Renal excretion of ions and water was studied in five men after ingestion of 3.57 mmol/kg body mass of sodium bicarbonate (NaHCO3) and, in a separate trial, potassium bicarbonate (KHCO3). 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. NaHCO3 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 KHCO3 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 KHCO3 and NaHCO3 solutions.

potassium bicarbonate; sodium bicarbonate; kidney; aldosterone; acid-base; strong ion difference; chloride; glomerular filtration rate; urine alkalinization


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