Kidney as a Source of Blood Ammonia: Effect of Chlorothiazide

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Abstract
Rapid and significant increases in the quantity of ammonia released into the renal veins were observed in 7 cirrhotic subjects given 500 mg of intravenous chlorothiazide. This increase in renal vein ammonia release was associated with an equally rapid increase in urine pH and a progressive rise in the arterial ammonia concentration. These observations demonstrate the kidney''s importance in the pathogenesis of chlorothiazide-induced hyperam-monemia and support the concept that alterations in urine pH influence the release of ammonia into the renal venous circulation.

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