Abstract
The distal renal tubular acidosis (RTA) syndromes are usually characterized by the presence of a hyperchloremic type of metabolic acidosis often associated to either hypokalemia (classic RTA) or hyperkalemia (hyperkalemic types of RTA). Some patients, however, have subtle defects in urinary acidification not manifested by hyperchloremic metabolic acidosis. The identification and classification of the various types of RTA are best approached from a mechanistic point of view and should take into consideration the site of the nephron responsible for the defect in acidification.
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References
Battle DC (1989) Renal tubular acidosis. In: Seldin DW, Giebisch G (eds) The regulation of acid-base balance. Raven, New York, pp 353–390
Steinmetz PR, Lawson WJ (1970) Defect in urinary acidification induced in vitro by amphotericin B. J Clin Invest 49: 596–601
Arruda JAL, Kurtzman NA (1980) Mechanism and classification of deranged distal urinary acidification. Am J Physiol 8: F515–523
Battle DC, Kurtzman NA (1982) Distal renal tubular acidosis: Pathogenesis and classification. Am J Kidney Dis 1: 128–144
DuBose TD Jr, Alpern RJ (1989) In: The metabolic basis of inherited disease. McGraw Hill pp 2539–2568
DuBose TD Jr, Calflisch CR (1985) Validation of the difference in urine and blood carbon dioxide transport during bicarbonate loading as an index of distal nephron acidification in experimental models of distal renal tubular acidosis. J Clin Invest 75: 1116–1123
Battle DC, Sabatini S, Kurtzman NA (1988) On the mechanism of toluene-induced renal tubular acidosis. Nephron 49: 210–218
Battle DC, Sehy JT, Roseman MK, Arruda JAL, Kurtzman NA (1981) Clinical and pathophysiologic spectrum of acquired distal renal tubular acidosis. Kidney Int 20: 389–396
Battle DC, Moses MF, Manaligod J, Arruda JAL, Kurtzman NA (1981) The pathogenesis of hyperchloremic metabolic acidosis associated with renal transplantation. Am J Med 70: 786–796
Battle DC (1986) Segmental characterization of defects in collecting tubule acidification. Kidney Int 30: 546–553
Battle DC, Hizon M, Cohen E, Gutterman C, Gupta R (1988) The use of the urinary anion gap in the diagnosis of hyperchloremic metabolic acidosis. N. Engl J Med 318: 594–599
Halperin ML, Goldstein MB, Haig A, et al. (1974) Studies on the pathogenesis of type 1 (distal) renal tubular acidosis as revealed by the urinary pCO2 tensions. J Clin Invest 53: 669–677
Battle DC (1986) Sodium-dependent urinary acidification in patients with aldosterone deficiency and adrenalectomized rats. Metabolism 35: 852–860
Battle DC (1981) Hyperkalemic hyperchloremic metabolic acidosis associated with selective aldosterone deficiency and distal renal tubular acidosis. Semin Nephrol 1: 260–274
Sebastian A, Schambelan M, Lindenfeld S, et al. (1977) Amelioration of metabolic acidosis with fluorocortisone therapy in hyporeninemic hypoaldosteronism. N Engl J Med 297: 576–589
Battle DC, Grupp M, Gaviria M, Kurtzman NA (1982) Distal renal tubular acidosis with intact ability to lower urine pH. Am J Med 72: 751–7510
Battle DC, Gaviria M, Grupp M, Arruda JAL, Wynn J, Kurtzman NA (1982) Distal nephron function in patients receiving chronic lithium therapy. Kidney Int 21: 477–485
Laski ME, Kurtzman NA (1983) Characterization of acidification in the cortical and medullary collecting tubule of the rabbit. J Clin Invest 72: 2050–2059
Battle DC, Arruda JAL, Kurtzman NA (1981) Hyperkalemic distal renal tubular acidosis associated with obstructive uropathy. N Engl J Med 304: 373–380
Schambelan M, Sebastian A, Rector FC Jr (1981) Mineralocorticoid-resistant renal hyperkalemia without salt wasting (type II pseudohypoaldosteronism): Role of increased renal chloride reabsorption. Kidney Int 19: 716
Rodriguez-Soriano J, Boichis H, Edelmann CM Jr (1967) Bicarbonate reabsorption and hydrogen ion excretion in children with renal tubular acidosis. J Pediatr 71: 802–813
Caruana RI, Buckalew VM Jr (1988) The syndrome of distal (Type I) renal tubular acidosis. Medicine, ( Baltimore ) 67: 84
Sebastian A, McSherry E, Morris RC Jr (1971) Renal potassium wasting in renal tubular acidosis ( RTA ). J Clin Invest 50: 667
Sebastian A, McSherry E, Morris RC Jr (1976) Impaired renal conservation of sodium and chloride during sustained correction of systemic acidosis in patients with Type I, classic renal tubular acidosis. J Clin Invest 58: 454–469
Wingo CS, Straub SC (1989) Active Proton Secretion and Potassium Absorption in the Rabbit Outer Medullary Collecting Duct. J Clin Invest 84: 361–365
Doucet A, Marsy S (1987) Characterization of K-ATPase activity in distal nephron: stimulation by potassium depletion. Am J Physiol 253 (Renal Fluid Electrolyte Physiol 22): F418 - F423
Garg LC, Narang N (1988) Ouabain-insensitive K-adenosine triphosphatase in distal nephron segments of the rabbit. J Clin Invest 81: 1204–1208
Nilwarangkur S, Nimmannit S, Chaovakul V, Susaengrat W, Ong-aj-yooth S, Vasuvattakul S, Pidetcha P, Malasit P (1989) Endemic Primary Distal Renal Tubular Acidosis in Thailand. Q J Med 74: 275, 289–301
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© 1991 Springer Japan
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Batlle, D.C., Keilani, T. (1991). Classification and Characterization of Types of Distal Acidification Defects in Humans. In: Hatano, M. (eds) Nephrology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-35158-1_121
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DOI: https://doi.org/10.1007/978-3-662-35158-1_121
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-70074-6
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