INFLUENCE OF PH ON RESERVOIR MUCOSAL ABSORPTION SECRETION AND TUBULARAND GLOMERULAR FUNCTION - STUDIES IN PATIENTS WITH A CONTINENT ILEAL RESERVOIR FOR URINARY-DIVERSION/

Ten patients with a continent ileal reservoir for urinary diversion we re studied regarding transmucosal fluxes of water and electrolytes at different pH. The urine was by-passed;the reservoir via a Foley cathet er. The experiment set-up was designed to exclude urine from reservoir mucosa exposition during the study. Test solutions of pH 4 and pH 7 w ith electrolytes and a non-absorbable volume marker (PEG MW 4000) were instilled into the empty reservoir. The influence of altered pH on th e flow of water and Na,(+),K+ and Cl- across the reservoir mucosa was analysed. The maximal concentration ability after intranasal desmopres sin (Minirin((R))), the creatinine and Na-clearance as well as the fra ctional Na-excretion were calculated from measurements on the by-passe d urine. The results showed a secretion of water, Na+ and Cl- into the reservoir while the K+ content was constant. The mucosal flows of wat er and electrolytes were not affected by alterations in reservoir pH. Maximal concentration ability appeared to be reduced compared to norma ls. Fractional Na excretion was within normal limits.