Hypochloremia as a consequence of anion gap metabolic acidosis. 1984

N E Madias, and S M Homer, and C A Johns, and J J Cohen

Anion gap acidosis is generally regarded as featuring a rather precise balance between the decrement in plasma HCO-3 and the increment in anion gap plasma Cl- remaining normal. In theory, therefore, the finding of hypochloremia in conjunction with an anion gap acidosis should evidence a coexisting metabolic alkalosis. In the clinical setting, however, hypochloremia is occasionally found in patients with anion gap acidosis but without exposure to a recognized alkalosis-inducing process. To examine the possibility that an element of hypochloremia might, under certain circumstances, be an integral part of the underlying acidosis, we studied three forms of anion gap acidosis in unanesthetized, nephrectomized rats. In protocol I, 7 mEq/kg H+ as H2SO4 was infused over 1 hour. In protocol II, 24 mEq/kg H+ as D,L-lactic acid was infused over 3 hours. In protocol III, rats were maintained in the anephric state for approximately 28 hours to permit uremic acidosis to develop. In each protocol, plasma C1- fell significantly (-8.0, -12.0, and -7.0 mEq/L in protocols I, II, and III, respectively) and contributed substantially to the observed increment in anion gap. A possible explanation for this acidosis-induced hypochloremia is expansion of the extracellular compartment secondary to the extrusion of cellular cation that occurs in the process of buffering.

UI MeSH Term Description Entries
D007773 Lactates Salts or esters of LACTIC ACID containing the general formula CH3CHOHCOOR.
D008297 Male Males
D011188 Potassium An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
D011919 Rats, Inbred Strains Genetically identical individuals developed from brother and sister matings which have been carried out for twenty or more generations or by parent x offspring matings carried out with certain restrictions. This also includes animals with a long history of closed colony breeding. August Rats,Inbred Rat Strains,Inbred Strain of Rat,Inbred Strain of Rats,Inbred Strains of Rats,Rat, Inbred Strain,August Rat,Inbred Rat Strain,Inbred Strain Rat,Inbred Strain Rats,Inbred Strains Rat,Inbred Strains Rats,Rat Inbred Strain,Rat Inbred Strains,Rat Strain, Inbred,Rat Strains, Inbred,Rat, August,Rat, Inbred Strains,Rats Inbred Strain,Rats Inbred Strains,Rats, August,Rats, Inbred Strain,Strain Rat, Inbred,Strain Rats, Inbred,Strain, Inbred Rat,Strains, Inbred Rat
D002712 Chlorides Inorganic compounds derived from hydrochloric acid that contain the Cl- ion. Chloride,Chloride Ion Level,Ion Level, Chloride,Level, Chloride Ion
D000138 Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are RESPIRATORY ACIDOSIS and metabolic acidosis, due to metabolic acid build up. Metabolic Acidosis,Acidoses,Acidoses, Metabolic,Acidosis, Metabolic,Metabolic Acidoses
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001639 Bicarbonates Inorganic salts that contain the -HCO3 radical. They are an important factor in determining the pH of the blood and the concentration of bicarbonate ions is regulated by the kidney. Levels in the blood are an index of the alkali reserve or buffering capacity. Bicarbonate,Bicarbonate Ions,Hydrogen Carbonates,Bicarbonate Ion,Carbonic Acid Ions,Hydrogen Carbonate,Carbonate, Hydrogen,Carbonates, Hydrogen,Ion, Bicarbonate,Ions, Bicarbonate,Ions, Carbonic Acid
D012964 Sodium A member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. Sodium Ion Level,Sodium-23,Ion Level, Sodium,Level, Sodium Ion,Sodium 23
D013464 Sulfuric Acids Inorganic and organic derivatives of sulfuric acid (H2SO4). The salts and esters of sulfuric acid are known as SULFATES and SULFURIC ACID ESTERS respectively. Acids, Sulfuric

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