tag:blogger.com,1999:blog-5872673930112727345.post3658742277795780643..comments2024-03-28T05:54:38.356-04:00Comments on Nephron Power: Consult Rounds: Why does infusion of normal saline cause metabolic acidosis?Kenar D Jhaveri( kidney 007)http://www.blogger.com/profile/08654527832183917798noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-5872673930112727345.post-17907943796081622222019-01-06T13:43:37.587-05:002019-01-06T13:43:37.587-05:00Normal saline infusion causes metabolic acidosis b...Normal saline infusion causes metabolic acidosis because there are 3 kinds of factors that affect the pH of a commercial saline solution: the atmosphere, the ions in solution, and the container. Commercial 0.9% saline solution for infusion has a pH around 5.5. There are many reasons for this acidity, some of them still obscure. It is also true that infusion of normal saline can lead to metabolic acidaemia, yet the link between the acidity of saline solution and the acidaemia it can engender is not straightforward.<br />Saline PVC packaging might be the another reason. IV Divisionhttps://www.ivdiv.com/noreply@blogger.comtag:blogger.com,1999:blog-5872673930112727345.post-70554599264754027222016-03-26T05:42:21.239-04:002016-03-26T05:42:21.239-04:00I think the SID theory could nicely explain that. ...I think the SID theory could nicely explain that. 1 liter of Isotonic Saline contains 154 mEq of Na and 154 mEq of Cl. Normal values of chloride in plasma range from 95 to 105 mEq/L (or mmol/l). Isotonic saline increases chloride concentration in blood(and the overall negative charge) In order to maintain electroneutrality cells (probably not only kidney cells;lung cells perhaps) compensates lowering Hco3 production.(which ,like chloride is an anion)My guess is that a load of chloride could shift carbonic anhydrase reaction to the right producing more Co2 and less Hco3. this could help maintain electroneutrality. A higher Co2 level increasing respiratory rate would eventually remove the Co2 load.Anonymoushttps://www.blogger.com/profile/18051239300053328917noreply@blogger.comtag:blogger.com,1999:blog-5872673930112727345.post-80141279021207151052013-10-08T09:30:03.864-04:002013-10-08T09:30:03.864-04:00That would suggest that the effect would only occu...That would suggest that the effect would only occur in patients with functioning kidneys and we know that this is not the case. Also, why would there be an increase in pendrin activation in the absence of chloride depletion?Gearoid McMahonhttps://www.blogger.com/profile/08049723797363526138noreply@blogger.comtag:blogger.com,1999:blog-5872673930112727345.post-52174346824020822002013-10-06T07:25:59.172-04:002013-10-06T07:25:59.172-04:00Nothing about excessive chloride shifting the pota...Nothing about excessive chloride shifting the potassium/proton exchange?Michael Hultströmhttps://www.blogger.com/profile/16994331638255846429noreply@blogger.comtag:blogger.com,1999:blog-5872673930112727345.post-85618891495362769822013-10-03T18:32:27.618-04:002013-10-03T18:32:27.618-04:00Another explanation is that increase in the amount...Another explanation is that increase in the amount of filtered chloride and delivery of chloride to the distal nephron caused by large infusions of normal saline provide the substrate for increased pendrin activity in intercalated type b cells. This would result in the reabsorption of chloride by the secretion of bicarbonate into the lumen leading to a metabolic acidosis. Ankit Patelhttps://www.blogger.com/profile/15958104858879313315noreply@blogger.com