European Journal of Pediatrics

, Volume 150, Issue 8, pp 547–549 | Cite as

Ammonium chloride metabolic acidosis and the activity of renin-angiotensin-aldosterone system in children

  • Z. S. Györke
  • E. Sulyok
  • J. -P. Guignard
Endocrinology Original Papers


The present study was undertaken to assess the effects of acute metabolic acidosis on the activity of the renin-angiotensin-aldosterone system in 12 children with a mean age of 8.9 years who underwent NH4Cl loading test. Ammonium chloride was given in a dose of 0.15 g/kg per day for 3 consecutive days to evaluate renal acidification. Prior to and following NH4Cl administration blood acid-base parameters, plasma and urine electrolytes, creatinine and aldosterone concentrations as well as plasma renin activity (PRA), urine flow rate and net H+ excretion were measured. Ammonium chloride administration significantly depressed blood pH (P<0.05), bicarbonate (P<0.01) and base excess (P<0.01) and resulted in a slight, but significant elevation of plasma potassium concentration (P<0.05). Furthermore, NH4Cl ingestion induced a marked increase in urine flow rate (P<0.01) and urinary sodium, potassium and chloride excretion (P<0.01). In response to NH4Cl metabolic acidosis, PRA doubled (4.72±1.18 vs 8.13±1.02 ng/ml per hour,P≤0.05) and there was a nearly fourfold increase in plasma aldosterone level (0.49±0.12 vs 1.52±0.24 ng/ml,P<0.01) and in urinary aldosterone excretion (19.2±4.3 vs 71.8±13.8 μg/day,P<0.01). The elevated aldosterone production observed in this study is assumed to be mediated by the combined effect of sodium and water diuresis-related increased PRA, hyperkalaemia and the direct stimulation of adrenal steroidogenesis by metabolic acidosis.


Aldosterone NH4Cl Metabolic Acidosis Ammonium Chloride Plasma Renin Activity 
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glomerular filtration rate


plasma renin activity


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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • Z. S. Györke
    • 1
  • E. Sulyok
    • 1
  • J. -P. Guignard
    • 2
  1. 1.County Children's HospitalPécsHungary
  2. 2.Service de PédiatrieCHUVLausanneSwitzerland

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