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Arch Hellen Med, 30(1), January-February 2013, 10-18


Metabolic acidosis from administration NaCl and parenteral nutrition.
Pathophysiological mechanisms

E.M. Pappas,1 E.C. Dounousi,1 K.P. Katopodis2
1Department of Nephrology, University Hospital of Ioannina, Ioannina,
2Department of Nephrology, General Hospital of Arta, Arta, Greece

Metabolic acidosis (MA) is one of the main four disorders of acid-base balance. The pathophysiological mechanisms responsible for MA are exogenous administration or increased endogenous production of acids, decreased excretion of renal acids that are normally produced on daily basis, and increased renal loss of bicarbonates (HCO3¯). Apart from renal failure, diabetic ketoacidosis, rhabdomyolysis, etc., ΜA can also be observed during the administration of acids or acid precursors, such as sodium chloride (NaCl), ammonium chloride, bromide, valproic acid, acetate anion (through hemodialysis dialysate) and sulphuric acid, and during total parenteral nutrition (TPN). This review describes the main pathophysiological mechanisms of MA caused by the intravenous administration of NaCl and TPN. The understanding of the pathophysiological mechanisms responsible for the occurrence of MA in both cases is useful and increasingly necessary, considering the frequency of intravenous administration of these solutions in everyday clinical practice.

Key words: Metabolic acidosis, NaCl, Parenteral nutrition.

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