Abstract
Studies were performed on normal human subjects to determine the effects of potassium depletion on urine acidification. Depletion was induced by ingestion of a low potassium diet either alone or in combination with a potassium-binding resin, and the response of each subject to an acute ammonium chloride load in the potassium-depleted state was compared to his normal response. Urine pH was significantly higher during potassium deficiency if sufficient potassium depletion had been induced. No differences in blood acid-base parameters, urinary flow rate, or urinary fixed buffer excretion rate were found to account for this change; however, the increase in urine pH was accompanied by a concomitant increase in net acid and ammonium excretion. It is proposed that these changes during potassium depletion reflect an increase in ammonia diffusion into the urine, presumably as a result of increased renal ammonia production. In addition, it is speculated that changes in ammonia metabolism may be a physiologic control mechanism for potassium conservation.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Annen R. L. The relationship between urine pH and acid excretion--the influence of urine flow rate. J Lab Clin Med. 1969 Nov;74(5):757–769. [PubMed] [Google Scholar]
- BAERTL J. M., SANCETTA S. M., GABUZDA G. J. Relation of acute potassium depletion to renal ammonium metabolism in patients with cirrhosis. J Clin Invest. 1963 May;42:696–706. doi: 10.1172/JCI104761. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BANK N., SCHWARTZ W. B. Influence of certain urinary solutes on acidic dissociation constant of ammonium at 37 degrees C. J Appl Physiol. 1960 Jan;15:125–127. doi: 10.1152/jappl.1960.15.1.125. [DOI] [PubMed] [Google Scholar]
- Buckalew V. M., Jr, McCurdy D. K., Ludwig G. D., Chaykin L. B., Elkinton J. R. Incomplete renal tubular acidosis. Physiologic studies in three patients with a defect in lowering urine pH. Am J Med. 1968 Jul;45(1):32–42. doi: 10.1016/0002-9343(68)90005-3. [DOI] [PubMed] [Google Scholar]
- CLARKE E., EVANS B. M., MACINTYRE I., MILNE M. D. Acidosis in experimental electrolyte depletion. Clin Sci. 1955 Aug;14(3):421–440. [PubMed] [Google Scholar]
- Cannon P. J., Ames R. P., Laragh J. H. Relation between potassium balance and aldosterone secretion in normal subjects and in patients with hypertensive or renal tubular disease. J Clin Invest. 1966 Jun;45(6):865–879. doi: 10.1172/JCI105402. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dunn M. J., Walser M. Magnesium depletion in normal man. Metabolism. 1966 Oct;15(10):884–895. doi: 10.1016/0026-0495(66)90159-4. [DOI] [PubMed] [Google Scholar]
- EDELMAN I. S., LEIBMAN J. Anatomy of body water and electrolytes. Am J Med. 1959 Aug;27:256–277. doi: 10.1016/0002-9343(59)90346-8. [DOI] [PubMed] [Google Scholar]
- FITZGERALD M. G., FOURMAN P. An experimental study of magnesium deficiency in man. Clin Sci. 1956 Nov;15(4):635–647. [PubMed] [Google Scholar]
- GANN D. S., DELEA C. S., GILL J. R., Jr, THOMAS J. P., BARTTER F. C. CONTROL OF ALDOSTERONE SECRETION BY CHANGE OF BODY POTASSIUM IN NORMAL MAN. Am J Physiol. 1964 Jul;207:104–108. doi: 10.1152/ajplegacy.1964.207.1.104. [DOI] [PubMed] [Google Scholar]
- GOLDSTEIN L. RELATION OF RENAL GLUTSMINE TRANSEMINASE-OMEGA-AMIDASE ACTIVITY TO AMMONIA EXCRETION IN THE RAT. Nature. 1964 Mar 21;201:1229–1230. doi: 10.1038/2011229a0. [DOI] [PubMed] [Google Scholar]
- Gabduzda G. J., Hall P. W., 3rd Relation of potassium depletion to renal ammonium metabolism and hepatic coma. Medicine (Baltimore) 1966 Nov;45(6):481–490. doi: 10.1097/00005792-196645060-00011. [DOI] [PubMed] [Google Scholar]
- Goodman A. D., Fuisz R. E., Cahill G. F., Jr Renal gluconeogenesis in acidosis, alkalosis, and potassium deficiency: its possible role in regulation of renal ammonia production. J Clin Invest. 1966 Apr;45(4):612–619. doi: 10.1172/JCI105375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Györy A. Z., Edwards K. D. Renal tubular acidosis. A family with an autosomal dominant genetic defect in renal hydrogen ion transport, with proximal tubular and collecting duct dysfunction and increased metabolism of citrate and ammonia. Am J Med. 1968 Jul;45(1):43–62. doi: 10.1016/0002-9343(68)90006-5. [DOI] [PubMed] [Google Scholar]
- IACOBELLIS M., MUNTWYLER E., GRIFFIN G. E. Enzyme concentration changes in the kidneys of protein- and/or potassium-deficient rats. Am J Physiol. 1954 Sep;178(3):477–482. doi: 10.1152/ajplegacy.1954.178.3.477. [DOI] [PubMed] [Google Scholar]
- IACOBELLIS M., MUNTWYLER E., GRIFFIN G. E. Kidney glutaminase and carbonic anhydrase activity and tissue electrolyte composition in potassium-deficient dogs. Am J Physiol. 1955 Dec;183(3):395–400. doi: 10.1152/ajplegacy.1955.183.3.395. [DOI] [PubMed] [Google Scholar]
- JOHNSON B. B., LIEBERMAN A. H., MULROW P. J. Aldosterone excretion in normal subjects depleted of sodium and potassium. J Clin Invest. 1957 Jun;36(6 Pt 1):757–766. doi: 10.1172/JCI103480. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LIDDLE G. W. Aldosterone antagonists. AMA Arch Intern Med. 1958 Dec;102(6):998–1004. doi: 10.1001/archinte.1958.00260230144018. [DOI] [PubMed] [Google Scholar]
- LOGSDON E. E. A method for the determination of ammonia in biological materials on the autoanalyzer. Ann N Y Acad Sci. 1960 Jul 22;87:801–807. doi: 10.1111/j.1749-6632.1960.tb23237.x. [DOI] [PubMed] [Google Scholar]
- Lennon E. J., Lemann J., Jr The effect of a potassium-deficient diet on the pattern of recovery from experimental metabolic acidosis. Clin Sci. 1968 Apr;34(2):365–378. [PubMed] [Google Scholar]
- MILLS J. N., THOMAS S., WILLIAMSON K. S. The effects of intravenous aldosterone and hydrocortisone on the urinary electrolytes of the recumbent human subject. J Physiol. 1961 May;156:415–423. doi: 10.1113/jphysiol.1961.sp006684. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitchell B. J., Gitelman H. J. A low electrolyte liquid diet suitable for metabolic studies. Am J Clin Nutr. 1968 Nov;21(11):1321–1324. doi: 10.1093/ajcn/21.11.1321. [DOI] [PubMed] [Google Scholar]
- RELMAN A. S., SCHWARTZ W. B. The nephropathy of potassium depletion; a clinical and pathological entity. N Engl J Med. 1956 Aug 2;255(5):195–203. doi: 10.1056/NEJM195608022550501. [DOI] [PubMed] [Google Scholar]
- RUBINI M. E. Water excrtion in potassium-deficient man. J Clin Invest. 1961 Dec;40:2215–2224. doi: 10.1172/JCI104448. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SCHWARTZ W. B., BANK N., CUTLER R. W. The influence of urinary ionic strength on phosphate pK2' and the determination of titratable acid. J Clin Invest. 1959 Feb;38(2):347–356. doi: 10.1172/JCI103808. [DOI] [PMC free article] [PubMed] [Google Scholar]
- STEINMETZ P. R., BANK N. Effects of acute increases in the excretion of solute and water on renal acid excretion in man. J Clin Invest. 1963 Jul;42:1142–1149. doi: 10.1172/JCI104799. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sonnenblick E. H., Cannon P. J., Laragh J. H. THE NATURE OF THE ACTION OF INTRAVENOUS ALDOSTERONE: EVIDENCE FOR A ROLE OF THE HORMONE IN URINARY DILUTION. J Clin Invest. 1961 Jun;40(6):903–913. doi: 10.1172/JCI104329. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WELT L. G., HOLLANDER W., Jr, BLYTHE W. B. The consequences of potassium depletion. J Chronic Dis. 1960 Mar;11:213–254. doi: 10.1016/0021-9681(60)90038-2. [DOI] [PubMed] [Google Scholar]
- WOEBER K. A., REID E. L., KIEM I., HILLS A. G. DIFFUSION OF GASES OUT OF THE DISTAL NEPHRONSEGMENT IN MAN. I. NH3. J Clin Invest. 1963 Nov;42:1689–1704. doi: 10.1172/JCI104855. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WRONG O., DAVIES H. E. The excretion of acid in renal disease. Q J Med. 1959 Apr;28(110):259–313. [PubMed] [Google Scholar]