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W. Denis and A. S. Minot

CONTENT OF URINE

NOTE ON THE CARBON DIOXIDE

ARTICLE:

1918, 34:569-575.J. Biol. Chem.

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NOTE ON THE CARBON DIOXIDE CONTENTOF URINE.

BY W. DENIS AND A. S. MINOT.(From the Chem ical Laboratory of the Massa chusetts General Hos pital, Boston.)

(Received for pu blicatio n,.Ap ril 24, 1918.)In the course of our investigation of certain problems which

involved the ingestion of small quantities of sodium bicarbonateit was found convenient to use the carbon dioxide content of theurine as a measure of bicarbonate excretion. In this connectionthe question at once presented itself as to what variations mustbe looked for in the excretion of urinary carbon dioxide underordinary normal conditions. A consultation of the literatureproved unfruitful. The recorded determinations of carbon dioxideare few in number lW5 and have been made under conditions ofsuch diversity that correlation of the various results appeareddifficult if not impossible.In view of this scarcity of data we have felt it desirable toplace on record the results of a limited series of observations onthe carbon dioxide content of normal human urine. The resultsof these experiments are tabulated below.Our determinations of carbon dioxide were made by means of theapparatus recently described by Van Slyke.6 Our figures representtherefore not only free CO2 but also CO2 existing in the form ofbicarbonates and carbonates. It was early found that the amountof COZ present in any urine varies inversely though not propor-tionately with the hydrogen ion concentration. The amount ofurine to be taken for a determination varies therefore from 5 cc.in strongly acid urines to 1 cc. in urines passedby persons on an

* Pfliiger, E., Arch. ges. Physiol., 1869, ii, 165.2 Ewald, C. A., Arch. Anat. u. Physiol., 1873, 1.3 Wurster, C., and Schm idt, A., Zentralbl. Physiol., 1887, i, 421.4 Van Niiys, T. C., and Lyons, R. E., Am. Chem. J., 1892, xiv, 16.5 Lieb lein, V., Z. phys iol. Chem ., 1895 , xx, 77.6 Van Slyke, D. D., J. Bio l. Chem ., 1917, xxx, 347.

569

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570 Carbon Dioxide Content of Urinealkaline vegetarian diet. In the urine of persons consuming anordinary mixed diet and excreting about 1 liter of urine per day,2 to 3 cc. of urine will usually be found a convenient amount to use.

As urine contains considerabIe and varying amounts of gas otherthan carbon dioxide (probably air) we have in every case made adouble extraction and have absorbed the carbon dioxide by meansof caustic potash according to Van Slykes directions. Thedeterminations of the hydrogen ion concentration were made bythe calorimetric method according to the technique describedby Henderson and Palmer.,

At the beginning of the work the question at once presenteditself as to whether the carbon dioxide content of urine changes onstorage. It is conceivable that in alkaline urines the carbondioxide content might increase on standing, and that in acidurines a diminution of CO might take place. Experimentalwork however proved that this was not the case, for, as indicatedby the following results, no change is demonstrable in the carbondioxide content of either acid or alkaline urines, preserved withchloroform, and kept in well stoppered containers at room tem-perature for 24 hours. As in our work it was always possr le tocomplete our analyses shortly after the closing of the 24 hour pe-riod we have not inquired into the question of the feasibility ofdetermining carbon dioxide in urines stored for longer periods.

Urine No.

12345

PH__-

cc.5.0 0.705.3 2.805.7 3.806.2 12.47.0 28.0

Cb2 per 100 cc. urine24 hrs. a fter voiding.cc.0.692.803.80

12.027.7

In Table I we have collected the results obtained by the de-termination of total carbon dioxide in twenty-six 24 hour urinescollected from six persons, in several of whom it was possibleto obtain a series of urines collected when the subject was taking avariety of diets of a fairly definite character.

7 Henderson, L. J., and Palmer, W. W., J. Biol. Chem., 1912-13, xiii, 398.

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W. Denis and A. S. Minot 571

Subject.

Mr. MCI

Mr. H.

Mr. L.

Miss W.Mr. T.

Miss M.

.--

D--

,.

-

aYV

1i&l co:for24 hrs.

-PH-

Food.

123

cc.990

1,050940

cc.34.759.146.1

4 930 362.0

Ordinary mixed diet. I ILow protein diet containing much

vegetables.

12

1,3002,700

6.a6.36.C6.15.45.7

101.2106.2

I

1 6002 740

4.3 3 weeks on high protein diet.9.6 3

1 900 29.7 Ordinary mixed diet.1 1,030 27.02 1,430 45.23 2,000 256.04 1,660 132.05 2,080 148.06 1,480 31.67 1,220 22.7

Low protein diet containing much

vegetables.I I

High protein. I

1 870 5.f 15.62 850 5.4 11.03 850 5.5 9.34 830 5.: 9.15 820 5.1 16.46 700 6.C 115.07 1,000 5.: 20.08 962 5.8 111.29 620 6.; 118.0

Eggs, beef, cheese, bread, butter, milk. I< I I

Mixed diet. I

Low protein diet containing muchvegetables.10

-1,000 7.C 333.0

-

TABLE I .Carbon D ioxide in Urine.

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572 Carbon Dioxide Content of Urine

-5

-

TABLE II.Carbon D ioxide in Urine (Sub ject A).

Time.

7-10 a.m.10 a.m.- 1 p.m.

1-4 4-7 7-10

10 p.m.- 4 a.m.4- 7 7-10 a.m.

10 a.m.- 1 p.m.l- 4 4-7 7-10

10 p.m.- 4 a.m.4-7 7-10 a.m.

10 a.m.- 1 p.m.l- 4 47 7-10

10 p.m.- 4 a.m.4-7 -

Urine.4

r 82 %I 3a :---cc. cc.130 6.1 5.4110 6.2 6.6

62 5.2 0.876 6.2 4.5

120 6.9 12.1

200 6.310.8190 7.134.7205 6.113.5180 6.2 6.5

93 5.6 1.3;13 6.0 4.5135 5.2 7.0280 6.1 9.5195 6.3 5.3448 5.715.2

90 5.3 1.485 6.0 1.5

120 6.1 4.9380 7.034.2

315 7.131.2175 7.115.4

Remarks.

Breakfast, 6.34 a.m.: banan a, bread,butter, coffee.

Lunch, 1 p.m.: roast beef, macaroni,butter, bread, jam.

Dinner, 6 p.m.: roast lamb, potatoes,peas, lettuce, salad, chees e, mincepie.

To tal COz for 24 hrs., 74.9 cc .Breakfast, 6.45 a.m.: 2 egg s, bread,

butter, 3 pt. milk, coffee .Lun ch, 1 p.m.: 6 egg s, bread;butter,

egg and milk pudding.Dinner, 6 p.m.: 200 gm. beefsteak,

bread, butter, egg and milk custard .Tota l CO, for 24 hrs., 47.6 cc.Breakfast, 6.45 a.m.: 1 banan a, 1

orange, 1 slic e bread, butter, coffee.Lunch, 1 p.m. : potato 300 gm., cabbage,

celery, lettuce, 1 slice bread, butter.Dinner, 6.30 p.m.: cau liflower, pota-

toes, carrots, tomatoes, onions,1 slic e bread, butter.

To tal COz for 24 hrs., 103.8 cc .

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TABLE III.Carbon Dioxide in Urine (Subject B)

/ TimeB1 7-10 a.m.

10 a.m.- 1 p.m.l- 4

4-7 7-10

10 p.m.- 4 a.m.4-7

3 7-10 a.m:10 a.m.- 1 p.m.

l- 4 4-7 7-10

10 p.m.- 1 a.m.l- 4 4-7 T 7-10 a.m.

10 a.m.- 1 p.m.l- 4 4-7 7-10

10 p.m.- 1 a.m.l-4 4-7

1 7-10 a.m.10 a.m.- 1 p.m. i20 5.4 11.4

l-4 137 5.1 1.24-7 .70 5.1 1.07-10 150 5.2 2.1

10 p.m.- 1 a.m. 165 5.2 Trace.l- 4 120 5.2 1.14-7 170 5.0 0.5

7

L

Urine.

cc. cc.182 7.0 75.5

88 7.0 32.142 6.1 5.9

51 7.2 48.9215 7.0 86.0

180 6.9 27.795 5.3 1.04---74 5.0 0.74

130 4.9 0.9181 5.0 0.4395 5.1 0.17

165 5.1 0.9095 5.0 0.17

115 4.8 1.3890 5.0 0.67--277 6.2 11.1

502 6.3 38.5277 6.0 8.8i29 6.5 93.3750 7.0 212.2L85 7.0 90.7

50 6.3 20.0110 5.8 6.0--____153 5.0 1.7 . I

Tota l CO, for 24 hrs., 19.0 cc.

Remarka,

Breakfast, 7.15 a.m. : 1 grape fruit,350 gm. potato.

Lunch, 1 p.m.: 400 gm. potato,string beans, apple, fruit salad,butter.

Dinner, 6.15 p.m. : 300 gm. potato,cauliflower, tomato, apple, 1slic e bread, butter.

Tota l COz fof 24 hrs., 277 cc.Breakfast, 7.15 a.m. : 2 egg s, bread,

butter, milk.Lunch, 1 p.m.: 4 eggs, cheese,

bread, butter. Dinner, 6.30 p.m.: 200 gm. beef-

steak, bread, butter.

To tal COz for 24 hrs., 5.37 cc .Same food as on 1st day. 3,800 cc.

water t.aken during day and night.

Tota l CO, for 24 hrs.. 481 cc.Same food as on 3rd day. 1,800 cc.

water taken during day.

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574 Carbon Dioxide Content of UrineThe results presented in this table indicate therefore the general

level of the carbon dioxide content of normal urine under variousdietary conditions. The minimum value 4.3 cc. of CO2 in 24hours (Mr. L.) was obtained in the case of a boy who for 3 weekshad lived on a strongly acid diet consisting of eggs, bread, cheese,milk, and oatmeal; the highest 362 cc. was that obtained in thecase of Mr. McL. who was taking a diet composed chiefly of greenvegetables, fruit, and potatoes, cream, and butter, with a littlebread.

It has long been known that the reaction of the urine changesfrequently during the course of the day, the alkaline tidewhich appears at varying times after eating having been a fruit-ful subject for student demonstrations for several decades.

In order to determine whether the variations in carbon dioxideexcretion during the day bear any relation to the taking of food,and incidentally to the changes in hydrogen ion concentrationsof the urine we have carried on a series of observations on the 3hour urines of two subjects who have eaten acid-high proteins,and an alkaline vegetarian diet. In one case observations arealso included when the subject was taking an ordinary mixeddiet, while in the case of the other subject we have introduced inthe table two experiments in which the intake of the water wasgreatly increased.

The experimental results obtained are incorporated in TablesII and III.From the results presented in these tables it is apparent that theexcretion of carhop dioxide, when observations are carried onduring 3 hour periods, varies with the reaction of the urine inapproximately the same manner as when collections are madein 24, hour amounts.

In both subjects carbon dioxide excretion appeared to havereached a maximum in the period between 7.00 and 10 .OO p.m.This phenomenon is especially striking during the days in whichthe alkaline vegetarian diet was given, although it is still to beseen in the days during which the food was of a more acid nature.

In as far as one can judge by the rather limited number of de-terminations the total carbon dioxide in the 24 hour urine from asubject taking the ordinary mixed diet may vary from 20 to 211 cc.

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W. Denis and A. S. Minot 575depending on what combinations of acid and basic foods happento be chosen by the individual.

The presence of sodium bicarbonate in considerable amountsin the strongly alkaline urine of the herbivora and of humanvegetarians has long been recognized. In view of our results wewish to call attention to the probable importance of bicarbonatein determining the reactions of neutral and amphoteric humanurines.

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