Renal acidification in sickle cell trait

Arch Intern Med. 1976 Jan;136(1):30-5.

Abstract

Nine sickle cell trait and nine control subjects underwent six-hour ammonium chloride acid loading. Maximal urine osmolality and renal hemodynamics were studied separately. Base line arterial pH, carbon dioxide pressure (Pco2), and [HCO3] were normal and comparable in the two groups. After ammonium chloride loading, urine pH decreased to 5.3 or less in all, and maximal excretion of ammonium and titratable and net acid was comparable as was urine minus blood Pco2 after bicarbonate loading. The ammonium chloride acidosis caused a small decrease in red blood cell 2,3-diphosphoglycerate levels but no alteration in oxygen pressure at 50% saturation at pH 7.4, sickling, or adverse effects. Control and sickle cell trait subjects had comparable renal hemodynamics but maximal urine osmolality was lower in sickle-cell trait subjects. Adults with sickle cell trait have diminished renal concentrating ability and normal renal acidification and hemodynamics.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acidosis, Renal Tubular / blood
  • Acidosis, Renal Tubular / complications
  • Acidosis, Renal Tubular / urine*
  • Adult
  • Ammonium Chloride / metabolism
  • Anemia, Sickle Cell / blood
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / urine*
  • Bicarbonates / metabolism
  • Blood
  • Carbon Dioxide / blood
  • Diphosphoglyceric Acids / blood
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Kidney Concentrating Ability
  • Male
  • Middle Aged
  • Osmolar Concentration
  • Oxygen / blood
  • Partial Pressure
  • Quaternary Ammonium Compounds / urine

Substances

  • Bicarbonates
  • Diphosphoglyceric Acids
  • Quaternary Ammonium Compounds
  • Ammonium Chloride
  • Carbon Dioxide
  • Oxygen