Studies on therapy of metabolic alkalosis during experimental uremia. Influences of arginine-hydrochloride on the intra- and extracellular acid-base status of the rat.

Severe metabolic alkalosis, combined with acute renal failure or uremia presents a difficult problem for the clinician. The standard treatment modalities of metabolic alkalosis are then limited and infusion of arginine-HCl is often tried in these cases. It was the purpose of this investigation to study the effects of arginine-HCl on the whole-body acid-base status during experimental uremia. While the extracellular acid-base status was determined from blood-gas measurements, the intracellular pH was calculated from the distribution of 5,5-dimethyl-2,4-oxazolidinedione. It was found that administration of arginine-HCl leads to a significant increase of intracellular pH though extracellular plasma pH decreases, and that arginine-HCl causes only an insignificant reduction of the intracellular bicarbonate concentration. The observed intracellular pH increase may have adverse consequences for patients and raises objections to the further use of arginine-HCl in the treatment of metabolic alkalosis, especially during renal failure or uremia.