Urine acidity in alcohol diuresis in man

Eggleton, M. Grace

doi:10.1113/jphysiol.1946.sp004124

Cited by 24 publications

(13 citation statements)

References 3 publications

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“…Theoretically, the dissociation of a weak acid, such as uric acid, can be expected to decrease in acid urine, and since ethanol administration may be accompanied by acidification of the urine, this could result in enhanced reabsorption of uric acid by back diffusion of the un-ionized form. In two out of three patients given ethanol, the rise in blood lactate was accompanied by urinary acidification, as had been described before (24,32). Urinary acidification, however, does not appear to be primarily responsible for the decrease in urinary uric acid output, since, in confirmation of previous findings (33), in the patient given sodium lactate, the urine became strongly alkaline; nevertheless, lactate administration was accompanied by a decrease in urinary uric acid output and a rise in serum uric acid similar to those observed in the same patient on alcohol administration, although the urine pH was about 5 in the latter condition (see Figures 6-8).…”

Section: Discussionsupporting

confidence: 68%

Interrelation of Uric Acid and Ethanol Metabolism in Man*

Lieber¹,

Jones²,

Losowsky³

et al. 1962

J. Clin. Invest.

286

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Traditionally, the drinking of large amounts of alcoholic beverages has been considered a common predisposing or precipitating cause of gout (1). Thus far, however, the possibility of a relationship between ethanol and urate metabolism does not seem to have been investigated. In an attempt to evaluate a possible effect of ethanol on uric acid metabolism, we have studied serum uric acid levels in patients intoxicated with ethanol. Having observed that ethanol leads to an elevation of serum uric acid concentration, we investigated the mechanisms of this effect.

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Section: Discussionsupporting

confidence: 68%

Interrelation of Uric Acid and Ethanol Metabolism in Man*

Lieber¹,

Jones²,

Losowsky³

et al. 1962

J. Clin. Invest.

286

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“…This increment is relatively Figure 5. Observations recorded from time to time over the past 15 years (17)(18)(19) show that urine tends, irrespective of starting pH, to approach pH 6.9 at 250 C (or 6.6 at 370 C); the phenomenon has not been explained. The data show that in normal man increasing urine flow rate by water-drinking increases urinary ammonia excretion, which confirms the most systematic studies previously reported of the effect of water diuresis on ammonia excretion in unprepared, healthy, fasting humans, those made 40 years ago by Hubbard and Munford (23,24).…”

Section: Methodsmentioning

confidence: 99%

Diffusion of Gases Out of the Distal Nephron-Segment in Man. I. Nh3*

Woeber¹,

Reid²,

Kiem³

et al. 1963

J. Clin. Invest.

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Physiologic variation in rate of urine flow in mammals is ascribed principally to reabsorption from distal tubules and collecting ducts of a varying quantity of nearly solute-free water (1-4). Water reabsorption is brought about by bulk flow or diffusion (5-8) incited by the difference in osmotic pressure between the luminal contents and the hypertonic fluid of the adjacent renal medullary interstitium, a process promoted by the action of endogenous vasopressin upon the permeability of the intervening membranes (7, 9). Elaboration of urine much less than maximally dilute increases the osmolality of luminal fluid as it progresses down the most distal portion of the nephron; the result must be to raise the diffusion pressure of all substances dissolved in luminal fluid.Two highly diffusible substances, the gases NH3 and CO2, are present in solution in luminal fluid together with their hydrated forms NH4OH and H2CO3, in turn in equilibrium, so as to constitute two buffer systems, with the ionized species NH4+ and HCO3-, respectively. If, as a result of the reabsorption of solute-free water, these gases are reabsorbed by diffusion, the existence and magnitude of the process should be reflected in alterations in the acid-base composition of voided urine no less than by changes in the rate of excretion of total ammonia and total carbon 1962-63. dioxide. Examination of the effects of water diuresis in normal man upon these various parameters has provided indirect evidence that the gases NH3 and CO2 do in fact diffuse out of the nephron's lumen during antidiuresis (10-12).1 This communication presents evidence that the rate of urinary ammonia excretion is largely determined by factors affecting the net diffusion of the free base NH3 into the distal portion of the nephron; the evidence further indicates that some NH3, having diffused into the lumen, subsequently diffuses back into the renal interstitium as a result of reabsorption of water from the lumen. METHODSExperimental design. Subjects were 12 healthy adult male volunteers whose rate of urinary flow was caused to vary between 1 ml per minute and the physiologic ceiling by controlled water-drinking. Serial, timed urine collections were made at intervals of about 12 minutes by voluntary emptying of the bladder. The individual experiments, generally comprising 20 or more collections, were begun about 8 a.m. in subjects who fasted overnight and remained upright during and for at least an hour before the experiment. When alkaline or mark-1 "Ammonia" means total ammonia. NH, includes NH4OH when ratios of the buffer species are in question, and HCO3 includes anhydrous CO, in the analagous context. NH4, is not considered a form of buffered H' except that "total H`" excretion includes NH,+.It has been inferred from experiments on toad bladder and other membranes (5) that vasopressin promotes osmotic movement of water out of the nephron by hydraulic flow through pores rather than by diffusion. The facts about the toad bladder are disputed (8), and there is no direct info...

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“…The most recent studies are those of Eggleton (10)(11)(12), whose subjects ingested alcohol diluted with considerable quantities of cider usually a few hours after breakfast. Her findings are in essential agreement with those to be reported below.…”

mentioning

confidence: 99%