Observations on the excretion of an acid urine in alkalosis.

Abstract

It has been customary to use the reaction of the urine as a guide to the therapeutic administration of sodium bicarbonate. In their most recent discussion of the subject Palmer, Salvesen and Jackson 1 state that the first significant effect on the pH of the urine, i. e., a rise to pH 7.0, can be taken as a safe and reliable guide for discontinuing alkali administration. This is probably true in the great majority of cases, but we believe that occasionally cases are encountered which do not readily excrete alkali, and that in such instances the reaction of the urine is not a safe criterion. We can record observations on two cases where the reaction of the urine remained strongly acid despite the development of an alkalosis. The data are self explanatory.