Role of citrate excretion in acid-base balance in diuretic-induced alkalosis in the rat

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Abstract
The role of changes in the excretion of citrate, a metabolic precursor of bicarbonate, in acid-base balance in diuretic-induced metabolic alkalosis was studied. Rats on a low-chloride diet with sodium sulfate added were studied during a base-line period, 3 days of furosemide administration and 4 days post-furosemide. During the period of furosemide administration, net acid excretion and plasma bicarbonate concentration increased. In the post-furosemide period, net acid excretion remained higher than base line but plasma bicarbonate concentration did not increase further. Citrate excretion was significanlty higher in the post-furosemide period than in base line. Studies substituting sodium neutral phosphate or sodium bicarbonate for dietary sodium sulfate demonstrated greater increases in net acid excretion post-furosemide and, again, no increase in plasma bicarbonate concentration during this period. Citrate excretion was greater than in the sulfate group. The increment in citrate excretion was proportional to the base load, defined with respect to changes in net acid excretion and/or dietary bicarbonate. Alterations of base excretion in the form of citrate evidently play an important role in acid-base balance during diuretic-induced metabolic alkalosis.