Question

Predict and explain the effects that alkalaemia might have on the excretion of the kidney of;

- Ethanol

Please explain this in detail (not just 1 or 2 sentences) because I need to know the mechanism in detail and I need a really good explanation!! If the answer is great, I will definitely give a thumps up, thankyou in advance :)

Answer 1

Medical Definition of alkalemia:

A condition in which the hydrogen ion concentration in the blood is decreased.

Causes:

Metabolic alkalosis is caused by too much bicarbonate in the blood. It can also occur due to certain kidney diseases. Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, such as from prolonged vomiting.

Both acute and chronic alcohol consumption can compromise kidney function,
particularly in conjunction with established liver disease. Investigators have observed
alcohol-related changes in the structure and function of the kidneys and impairment in
their ability to regulate the volume and composition of fluid and electrolytes in the
body. Chronic alcoholic patients may experience low blood concentrations of key
electrolytes as well as potentially severe alterations in the body’s acid-base balance.
In addition, alcohol can disrupt the hormonal control mechanisms that govern kidney
function. By promoting liver disease, chronic drinking has further detrimental effects
on the kidneys, including impaired sodium and fluid handling and even acute kidney
failure.

A cell’s function depends not only on receiving a continuous supply of nutrients and eliminating metabolic waste products but also on the existence of stable physical and chemical conditions in the extracellular fluid1 bathing it. Among the most important substances contributing to these conditions are water, sodium, potassium, calcium, and phosphate. Loss or retention of any one of these substances can influence the body’s handling of the others. In addition, hydrogen ion concentration (i.e., acid-base balance) influences cell structure and permeability as well as the rate of metabolic reactions. The amounts of these substances must be held within very narrow limits, regardless of the large variations possible in their intake or loss. The kidneys are the organs primarily responsible for regulating the amounts and concentrations of these substances in the extracellular fluid.

Normally the rate of blood flow or perfusion, (i.e., hemodynamics) through the kidneys is tightly controlled, so that plasma can be filtered and substances the body needs can be reabsorbed under optimal circumstances (see sidebar). Established liver disease impairs this important balancing act, however, by either greatly augmenting or reducing the rates of plasma flow and filtration through the glomerulus. Investigators have not yet fully explained the mechanisms underlying this wide range of abnormalities, though, and have devoted little attention to alcohol’s effects on kidney hemodynamics in people who do not have liver disease.

Results of subsequent studies in animal models seem to vary according to the species examined, the route and dose of alcohol administration, and the length of time after administration for which the study groups were observed. For example, some studies implied that acute alcohol consumption does not significantly change kidney hemodynamics or sodium excretion in dogs, but these studies did not extend beyond 6 hours after alcohol ingestion. In contrast, earlier studies that examined dogs for a longer period reported that a single dose of 3 grams of alcohol per kilogram of body weight (g/kg) elevated plasma volume between 10 and 26 hours following alcohol ingestion (Nicholson and Taylor 1940).3 Another study with dogs (Beard et al. 1965) disclosed that the effects of chronic alcohol consumption endured even longer. The investigators noted increased plasma and extracellular fluid volume 1 week after chronic alcohol ingestion, and these volume expansions persisted for the remaining 7 weeks of the study. Similar alterations have been found in body fluid volumes among chronic alcoholic patients.