The effects of Na2SO4 on the pattern of urinary acid excretion were studied in 6 normal subjects and 14 patients with chronic renal disease when the serum bicarbonate concentration was normal and reduced. The infusion of Na2SO4 into patients with renal disease resulted in a rise in urine pH and bicarbonate excretion when the serum bicarbonate was normal. In contrast, normal subjects consistently excreted a more acid urine in response to Na2S04. During metabolic acidosis, the infusion of Na2SO4 in the patients resulted in urinary acidification. These findings suggest that in renal failure nephron overperfusion will flood the distal tubule with NaHCO3 and impair urinary acidification even when a potent acidifying salt such as Na2SO4 is given. The inability of Na2O4 to acidify the urine of the diseased kidney indicates that this is not an expression of intrinsic tubular damage and this is seen in the effects of metabolic acidosis when Na2SO4 is able to elicit maximum urinary acidification. The findings permit a tentative reconstruction of some of the factors responsible for the metabolic acidosis of renal failure.
|Original language||English (US)|
|Number of pages||11|
|Journal||The Journal of laboratory and clinical medicine|
|State||Published - Jun 1 1967|
ASJC Scopus subject areas
- Pathology and Forensic Medicine