"Contraction" Alkalosis After Diuresis of Edematous Patients with Ethacrynic Acid
Authors: P. J. CANNON
Journal: Annals of Internal Medicine (1965)

Article1 May 1965"Contraction" Alkalosis After Diuresis of Edematous Patients with Ethacrynic AcidP. J. CANNON, M.D., H. O. HEINEMANN, M.D., M. S. ALBERT, M.D., J. H. LARAGH, M.D., R. W. WINTERS, M.D.P. J. CANNON, M.D.Search for more papers by this author, H. O. HEINEMANN, M.D.Search for more papers by this author, M. S. ALBERT, M.D.Search for more papers by this author, J. H. LARAGH, M.D.Search for more papers by this author, R. W. WINTERS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-979 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSystemic alkalosis has been observed (1) after diuresis of patients with ethacrynic acid, a new potent oral diuretic. In the present study, metabolic balance studies were performed on four patients with congestive heart failure in order to define the pathogenesis of this alkalosis. The results indicate that in these patients with edema, the acid-base disturbance observed after ethacrynic acid therapy resulted primarily from a large acute contraction of the extracellular fluid space produced by the large saluresis and diuresis caused by the drug. Urinary losses of relatively bicarbonate free fluid caused the extracellular space to contract around the initial extracellular...References1. CANNONAMESLARAGH PJRPJH: Methylenebutyryl phenoxyacetic acid. Novel and potent natriuretic and diuretic agent. JAMA 185: 854, 1963. CrossrefMedlineGoogle Scholar2. HEINEMANNDEMARTINILARAGH HOFEJH: Effect of chlorothiazide on renal excretion of electrolytes and free water. Amer. J. Med. 26: 853, 1959. CrossrefMedlineGoogle Scholar3. SIGGAARD-ANDERSON O: The Acid-Base Status of the Blood. Munksgaard, Copenhagen, 1964, 88 pp. Google Scholar4. ELKINTONDANOWSKI JRTS: The Body Fluids. The Williams & Wilkins Co., Baltimore, 1955, 626 pp. Google Scholar5. ELKINTON JR: Hydrogen ion turnover in health and in renal disease. Ann. Intern. Med. 57: 85, 1962. LinkGoogle Scholar6. SINGERCLARKBARKERCROSLEYELKINTON RBJKESAPJR: The acute effects in man of rapid intravenous infusion of hypertonic sodium bicarbonate solution. Medicine (Balt.) 34: 51, 1955. CrossrefMedlineGoogle Scholar7. WORTHINGGEFFNER AGJ: Treatment of Experimental Data. John Wiley & Sons, Inc., New York, 1943. Google Scholar8. CANNONHEINEMANNSTASSONLARAGH PJHOWBJH: Ethacrynic acid: effectiveness and mode of diuretic action in man. In press. Google Scholar9. BAERRUSSOMICHAELSONBEYER JEHFJKKH: A new class of diuretic-saluretic agents, the αβ-unsaturated ketone derivatives of aryloxyacetic acids. Pharmacologist 4: 158, 1962. Google Scholar10. GOLDBERGMCCURDYFOLTZBLUEMLE MDKEFLW: Effects of ethacrynic acid (a new saluretic agent) on renal diluting and concentrating mechanisms: evidence for site of action in the loop of Henle. J. Clin. Invest. 43: 201, 1964. CrossrefMedlineGoogle Scholar11. SCHWARTZHAYSPOLAKHAYNIE WBRMAGD: Effects of chronic hypercapnia on electrolyte and acid-base equilibrium. II. Recovery, with special reference to influence of chloride intake. J. Clin. Invest. 40: 1238, 1961. CrossrefMedlineGoogle Scholar12. ATKINSSCHWARTZ ELWB: Factors governing correction of alkalosis associated with potassium deficiency; critical role of chloride in recovery process. J. Clin. Invest. 41: 218, 1962. CrossrefMedlineGoogle Scholar13. RELMANETSTENSCHWARTZ ASBWB: The regulation of renal bicarbonate reabsorption by plasma CO2 tension. J. Clin. Invest. 32: 978, 1953. CrossrefGoogle Scholar14. BRAZEAUGILMAN PA: Effect of plasma CO2 tension on renal tubular reabsorption of bicarbonate. Amer. J. Physiol. 75: 33, 1955. Google Scholar15. GOODMANFUISZ ADRE: Mechanism of regulation of renal bicarbonate reabsorption by plasma CO2 tension. Amer. J. Physiol. 206: 719, 1964. CrossrefMedlineGoogle Scholar16. WINTERSSCAGLIONENAHASVEROSKY RWPRGGM: The mechanism of acidosis produced by hyperosmotic infusions. J. Clin. Invest. 43: 647, 1964. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New YorkFrom the Departments of Medicine and Pediatrics, College of Physicians and Surgeons, Columbia University, New York, N. Y.This study was supported by grants 1-R01-HD-00117-01, HE-01275, and HE-05741 from the U. S. Public Health Service, Bethesda, Md.Portions of this study were presented in the American Physiological Society, Federation Proceedings 23: 307, 1964.Requests for reprints should be addressed to Paul J. Cannon, M.D., Department of Medicine, College of Physicians and Surgeons, Columbia University, 3975 Broadway, New York, N. Y. 10032. 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WINTERS, M.D.Acid-Base Disorders and the ClinicianJ. R. E. 1 May 1965Volume 62, Issue 5Page: 979-990KeywordsAttentionDiureticsDrug therapyEdemaHeart failureLongitudinal studiesMedical servicesPathogenesisPediatricsSurgeons Issue Published: 1 May 1965 PDF DownloadLoading ...