Experimental studies on therapy of metabolic alkalosis during the beginning of uremia. Influences of ammonium chloride on the intra- and extracellular acid-base status of the rat.

Abstract

Metabolic alkalosis during renal failure or uremia presents a difficult problem for the clinician. In this study the effects of ammonium chloride, an agent clinically used for the correction of severe metabolic alkalosis, were studied on the extra- and intracellular acid-base balance of nephrectomized rats. While the extracellular acid-base status was determined from blood gas measurements, intracellular pH was calculated from the distribution of 5,5-dimethyl-2,4-oxazolidinedione. It was found that the administration of NH4Cl leads to a significant increase of intracellular pH though extracellular plasma pH decreases, and that ammonium chloride causes only an insignificant reduction of the intracellular bicarbonate concentration. The observed intracellular pH increase may have adverse consequences for patients and raises objections to the further use of ammonium chloride in the treatment of metabolic alkalosis, especially during renal failure or uremia.