EXTERNAL NET ACID BALANCE (NAB) IN INFANTS WITH CHRONIC DIARRHEA CONSEQUENT TO ACQUIRED GLUCOSE INTOLERANCE (AGI)

Abstract

A close relationship exists between the presence of a watery and acidic diarrhea and the development of metabolic acidosis in AGI infants. With the objective to identify possible mechanisms of acidosis, 12 malnourished infants, 2 to 17 months old were studied during 3 to 4 days, by the NAB technique, divided in : Group 1 - infants with diarrhea, glucose in stools, and acidosis; Group 2 - infants who tolerated formula feedings well and free of acidosis. Endogenous acid production (AP) was significantly higher in group 1: 3.69 ± 1.92 vs 0.45 - 1.70 mEq/kg/day (p < .002). Urinary excretion of sulfate was similar in both groups and organic acids (OA) were higher in group 1 (p < .05). Absorbed undetermined anions (UA) were significantly different between the groups, positive in group 2, representing base gained : 1.65 ± 1.80 mEq/kg and negative in group 1, representing produced and gained acid: -022 ± 1.85 mEq/kg (p < .05). Urinary net acid excretion (NAE) was similar in both groups, observing group 1 who had inappropriated high urinary pH and bicarbonaturia. We concluded that the metabolic acidosis was conditioned largely by the overproduction of intestinal OA as well as urinary excretion of AO as salts. Impairment in NAE was the factor responsible for maintaining systemic acidosis in group 1.

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