23 Mar 2025 04:46

Chapter Eighteen: Metabolic Alkalosis, part 1

We are a bit slappy at the beginning of the episode since we had just recorded our conversation with the Glaucomfleckens. References

Chapter 18 Metabolic alkalosis! 

Part 1 February 23, 2023

It is chloride depletion alkalosis, not contraction alkalosis classic review by Galla and Luke, the metabolic alkalosis mavens who review the role of chloride.

On the mechanism by which chloride corrects metabolic alkalosis in man and this is the study when they induced a metabolic alkalosis and studied the effect of treating with KCl vs NaPhos and found the former (with chloride) reversed the alkalosis but not the sodium containing protocol. 

Some elegant reports on the increased proximal reabsorption of bicarbonate above normal stimulated by Ang II. 

Tubular transport responses to angiotensin | American Journal of Physiology-Renal Physiology

Crosstalk between the renal sympathetic nerve and intrarenal angiotensin II modulates proximal tubular sodium reabsorption - Pontes - 2015 - Experimental Physiology - Wiley Online Library

THE RENAL REGULATION OF ACID-BASE BALANCE IN MAN. III. THE REABSORPTION AND EXCRETION OF BICARBONATE 1949  this is the correct figure for 11.14 and shows what happens when filtered bicarb exceeds normal threshold in normal human (men) and appears in the urine. 

Masterful review Symposium on acid-base homeostasis. The generation and maintenance of metabolic alkalosis by Seldin and Rector 

And a modern review from Michael Emmet! Metabolic Alkalosis - PMC (so many favorite reviews on this exciting topic!) and this one from Soleimani Metabolic Alkalosis Pathogenesis, Diagnosis, and Treatment: Core Curriculum 2022 both of these elaborate on pendrin’s role. 

The effect of prolonged administration of large doses of sodium bicarbonate in man  (Clin Sci. 1954 Aug;13(3):383-401)

Kidney v Renal: KDIGO versus Don’t

Plus: We got a little off topic and discussed the Kidney Failure Risk Equation:


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