[The mechanism maintaining severe metabolic alkalosis]
1Department of Anesthesiology, Kenwakai Ohtemachi Hospital, Kitakyushu.
Abstract:
The pathogenesis of severe metabolic alkalosis was studied from the following three points of view; 1) effect of administration of alkalosing agents in rats, 2) amino acids in blood and muscle and 3) renal ammoniagenesis in control and K-depleted rats. The weight gain was significantly depressed in all kinds of alkalosis. Lysine increased remarkably, especially over 10 times in muscle, but Fischer's ratio decreased significantly in blood and muscle of K-depleted rats. Glutamine is the main source in ammoniagenesis, and ammonia (NH4+) is the main substance of H+ secretion from kidney. Though the concentration of glutamine was unchanged in blood and muscle, ammoniagenesis increased 2.5 times, compared with control in renal tubules suspension of K-depleted rat. In conclusion, increase in renal ammonia production would be one of the most important ways to maintain severe metabolic alkalosis.
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