Glucose-induced alkalosis in fasting subjects

Stinebaugh, Bobby J.; Schloeder, Francis X.

doi:10.1172/jci106929

Cited by 24 publications

(3 citation statements)

References 18 publications

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“…The results of these experiments describing the pattern of sodium excretion during early fasting are in accord with considerable previous works, (2,3,6,7,8). However, the present experiments are unique in that they measure changes in sodium and other major cation excretions continuously in 3-h intervals during many days of fasting.…”

Section: Discussionsupporting

confidence: 90%

“…1 of their paper (29) shows a relatively minimal increase in chloride excretion during the 1st wk of fasting at a time when sodium excretion is rapidly increasing. In a more recent paper these workers suggest that the pattern of chloride loss follows that of sodium loss (2). However, it is evident in their data that although the pattern or directional change is the same, quantitatively, sodium loss far exceeds chloride loss by at least twofold when comparing their Fig.…”

Section: Discussionmentioning

confidence: 94%

“…Cumulative negative sodium balance markedly exceeds that which would occur with sodium deprivation alone (1). Also, negative sodium balance occurs even when prefast sodium intake is maintained during fasting (2,3). Although numerous explanations of this diuresis have been proposed, the mechanism has not been established.…”

Section: Introductionmentioning

confidence: 99%

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The mechanism of the natriuresis of fasting.

Sigler¹

1975

J. Clin. Invest.

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A B S T R A C T This study tests the hypothesis that obligatory cation coverage of metabolically generated anions is the mechanism for the sodium diuresis of fasting. Nine obese female subjects were equilibrated on a constant sodium and caloric intake and then fasted while sodium intake was maintained. Particular attention was paid to maintaining the same upright activity schedule during fasting as during control. Consecutive 3-h increases in urinary sodium, ammonium, and potassium excretion during fasting were matched against simultaneously determined increases in organic acid anions (OAS) and H2PO4-, which would exist in combination with the cations. The changes were significantly correlated (r = 0.891, P < 0.001) in the relationship y = 0.73x + 19 where y equals increases in organic acid salts + H2PO4-and x equals increases in cations. As ammonium excretion rose, sodium conservation occurred with ammonium replacing sodium at the major urinary cation. Corollaries to the hypothesis were also found to be true. They were: (a) Increases in ammonium excretion lagged considerably behind increases in OAS + H2PO4c during the diuretic phase making sodium coverage necessary. (b) Sodium loss was much greater than chloride although chloride balance was minimally negative. (c) After refeeding with glucose, sodium excretion promptly decreased and appeared best correlated with simultaneous decreases in OAS. Ammonium excretion also fell but much less than sodium. The data support the hypothesis that obligatory cation coverage of metabolically generated anions is a major mechanism responsible for the sodium diuresis of fasting. INTRODUCTIONLarge quantities of electrolyte and water are lost in the urine during the 1st wk of fasting. The principal

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%