Alterations in acid-base homeostasis during water immersion in normal man

The effects of water immersion on renal bicarbonate and acid excretion were assessed in 10 normal male subjects. Immersion resulted in a highly significant progressive increase in the rate of sodium and bicarbonate excretion, and in urine pH. Immersion was also associated with a significant increase in urine P-CO2; this increase presupposes a maintained rate of hydrogen secretion in the distal tubular segment. The rapidity of onset of the bicarbonaturia (2 hrs of immersion) and the concomitant increase in urinary P-CO2 suggest that enhanced bicarbonate excretion of immersion cannot be completely accounted for by immersion-induced suppression of aldosterone, and that the natriuresis and bicarbonaturia of immersion is mediated in part by an increased proximal rejection of sodium and bicarbonate.