What is an alternative to the ammonium chloride (NH4 Cl) loading test in the workup of metabolic acidosis?

Updated: Oct 10, 2018
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

An alternative to the NH4 Cl loading test involves the simultaneous oral administration of furosemide to increase distal Na+ delivery and fludrocortisone to increase collecting duct Na+ absorption and proton secretion. [9] Under these circumstances, a urine pH greater than 5.3 indicates distal RTA.


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