AJP - Renal Physiology, Vol 245, Issue 4 425-F432, Copyright © 1983 by American Physiological Society
On the generation, maintenance, and correction of metabolic alkalosis
H. R. Jacobson and D. W. Seldin
The study of derangements in salt, water, and acid-base homeostasis
frequently reveals much about renal transport mechanisms and their
regulation. The study of one such derangement, metabolic alkalosis, has
played a special role in contributing to our knowledge of renal function.
Elucidation of the kidney's role in the generation, maintenance, and
correction of metabolic alkalosis has provided information about proximal
tubule transport and its response to volume contraction, volume expansion,
and K depletion. Also, distal nephron transport and its response to
mineralocorticoids and dietary anion composition has been clarified by
studies on metabolic alkalosis. Finally, we have learned about the
importance of Na delivery to distal nephron sites and the avidity with
which these distal nephron sites reabsorb sodium. Indeed, reviews on the
subject of metabolic alkalosis have presented thorough and convincing
physiologic arguments on how the kidney helps to generate and maintain this
derangement in acid-base balance. However, more recent experimental work
has led some to reconsider how the kidney functions in metabolic alkalosis.
In an earlier paper in this journal [Am. J. Physiol. 244 (Renal Fluid
Electrolyte Physiol. 13): F217-F221, 1983], Galla, Bonduris, and Luke
present an argument for the correction of chloride-depletion alkalosis in
the rat without volume expansion.(ABSTRACT TRUNCATED AT 250 WORDS)
