The role of potassium in the prevention of alkalosis

The Role of Chloride in Hypokalemic Alkalosis in the Rat*

“…In this respect rats resemble dogs (9) and patients with primary hyperaldosteronism (10). The results reported here are not in agreement with those of Cooke and co-workers (8), who demonstrated complete correction of both abnormal plasma composition and potassium deficiency in rats after the administration of a daily supplement of potassium bicarbonate, 6 mmoles per kg body weight for 3 days. In the absence of analytical data it might tentatively be suggested that the intrinsic chloride content of the diet used in those experiments exceeded that in the present studies.…”

“…The period of 4 days on low salt diet that preceded the repletion period in the experiments of Cooke and associates might further explain some of the differences in results between the two studies. It should further be mentioned that the administration of sodium bicarbonate to potassium-deficient rats was shown to result in chloride depletion (8). In the present studies in experiment II during the last 5 days of the depletion period the daily sodium chloride supplement of 6 mmoles per kg body weight was changed into sodium bicarbonate.…”

“…On indirect evidence Cooke and associates (8) suggested that hypochloremia in potassium deficiency was the result not of chloride loss but rather of expansion of extracellular fluid volume. Balance studies in potassium-deficient dogs (9) and in humans with primary hyperaldosteronism (10), however, showed that in potassium deficiency extracellular alkalosis is accompanied by chloride deficiency.…”

“…6 Individual values for all animals were calculated as potassium and sodium contents of 1 kg fat-free wet carcass minus those of 0.5 kg fat-free wet muscle. Hypochloremia in potassium deficiency could be an expression of chloride deficiency, or the result of expansion of extracellular fluid volume (18), or a combination of these two (8). The value of the volume of distribution of chloride as a measure of extracellular fluid volume is questionable in a period when considerable changes in acid-base and in chloride balance take place.…”

THE EXCRETION OF l-MALIC ACID IN RELATION TO THE TRICARBOXYLIC ACID CYCLE IN THE KIDNEY*

“…Under certain circumstances the excretion of some of these acids shows remarkable variations. For instance, in metabolic alkalosis the rate of excretion of citrate and to a lesser extent of a-ketoglutarate is greatly elevated (3)(4)(5)(6). On the other hand, in metabolic acidosis, or more precisely in conditions favoring intracellular acidosis such as potassium deficiency (4,5) or the administration of Diamox@ (7), the rate of excretion of these same acids is reduced almost to zero.…”