Effect of acute reversal of experimentally-induced ketoacidosis with sodium bicarbonate on the plasma concentrations of phosphorus and potassium

To determine if ketoacidosis per se, or its reversal with NaHCO 3, predisposes to hypophosphatemia, six conditioned dogs were infused for two hours with 3.0 mmol/kg body wt/hour of beta-hydroxybutyric acid, followed by 1.5 mmol/kg/hour of NaHCO 3 for two hours. Acid infusion caused moderate decrements in blood pH and [HCO 3], a 23±4% increase in plasma [P] (p < 0.005), and a 15±3% decrease in plasma [K] (p < 0.005). NaHCO 3 administration returned blood pH and [HCO 3] levels to or slightly greater than baseline. Plasma [P] decreased, but not below baseline, whereas plasma [K] remained below baseline, and underwent an additional small decline (p < 0.01). We conclude that acute correction of experimental ketoacidosis with NaHCO 3 reverses the characteristic hyperphosphatemia but does not induce hypophosphatemia. On the other hand, NaHCO 3 administration appeared to contribute to the perpetuation of hypokalemia.