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Am J Physiol Renal Physiol 282: F1049-F1055, 2002. First published January 8, 2002; doi:10.1152/ajprenal.00006.2001
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Vol. 282, Issue 6, F1049-F1055, June 2002

Mechanisms used to dispose of progressively increasing alkali load in rats

Surinder Cheema-Dhadli1, Shih-Hua Lin2, and Mitchell L. Halperin1

1 Renal Division, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada M5B 1A6; and 2 Renal Division, Tri-Service General Hospital, National Defense Medical Center, Taipei 100, Taiwan

Our objective was to describe the process of alkali disposal in rats. Balance studies were performed while incremental loads of alkali were given to rats fed a low-alkali diet or their usual alkaline ash diet. Control groups received equimolar NaCl or KCl. Virtually all of the alkali was eliminated within 24 h when the dose exceeded 750 µmol. The most sensitive response to alkali input was a decline in the excretion of NH<UP><SUB>4</SUB><SUP>+</SUP></UP>. The next level of response was to increase the excretion of unmeasured anions; this rise was quantitatively the most important process in eliminating alkali. The maximum excretion of citrate was ~70% of its filtered load. An even higher alkali load augmented the excretion of 2-oxoglutarate to >400% of its filtered load. Only with the largest alkali load did bicarbonaturia become quantitatively important. We conclude that renal mechanisms eliminate alkali while minimizing bicarbonaturia. This provides a way of limiting changes in urine pH without sacrificing acid-base balance, a process that might lessen the risk of kidney stone formation.

acid-base balance; ammonium; bicarbonate; citrate; net acid excretion; organic anions; 2-oxoglutarate


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