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Titolo:
THE SPECTRUM OF ENDEMIC RENAL TUBULAR-ACIDOSIS IN THE NORTHEAST OF THAILAND
Autore:
VASUVATTAKUL S; NIMMANNIT S; CHAOVAKUL V; SUSAENGRAT W; SHAYAKUL C; MALASIT P; HALPERIN ML; NILWARANGKUR S;
Indirizzi:
MAHIDOL UNIV,SIRIRAJ HOSP,DEPT MED,RENAL UNIT,RENAL DIV BANGKOK 10700THAILAND KHON KAEN HOSP,DIV RENAL KHON KAEN THAILAND UNIV TORONTO,ST MICHAELS HOSP,DIV RENAL TORONTO ON M5B 1W8 CANADA
Titolo Testata:
Nephron
fascicolo: 3, volume: 74, anno: 1996,
pagine: 541 - 547
SICI:
0028-2766(1996)74:3<541:TSOERT>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSTUBULAR POTASSIUM CONCENTRATION; INTRACELLULAR PH; AMMONIAGENESIS; RATS; HOMEOSTASIS; HYPOKALEMIA; DEPLETION; EVALUATE; INVIVO; HUMANS;
Keywords:
RENAL TUBULAR ACIDOSIS; POTASSIUM DEFICIENCY; INTRACELLULAR ACIDOSIS; AMMONIUM PRODUCTION; TUBULOINTERSTITIAL INJURY; URINARY CITRATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
S. Vasuvattakul et al., "THE SPECTRUM OF ENDEMIC RENAL TUBULAR-ACIDOSIS IN THE NORTHEAST OF THAILAND", Nephron, 74(3), 1996, pp. 541-547

Abstract

We have previously reported a high prevalence of endemic renal tubular acidosis (EnRTA) in the northeast of Thailand, and our subsequent studies provided evidence that K deficiency exists in the same region. Since tubulointerstitial damage is associated with K deficiency, we postulate that this might be implicated in the pathogenesis of EnRTA and,if so, that a spectrum of tubulointerstitial abnormalities can be anticipated. In this study we evaluated renal acidification ability in 4 patients and in 11 of their relatives. We used a 3-day acid load (NH4Cl 0.1 g/kg/day) followed by 20 mg oral furosemide and monitored the maximal renal concentrating ability using water deprivation and intranasal 1-deamino-D-arginine vasopressin. The results showed that the subjects could be divided into three groups: normal relatives of the patients, those with suspected renal tubular acidosis, and patients with overt EnRTA who had chronic metabolic acidosis and a low rate of excretion of NH4+. The rate of excretion of K was very low (20 +/- 4 mmol/day)in patients with EnRTA and in their relatives with suspected EnRTA. The transtubular K concentration gradient was also very low in their relatives, especially in patients with suspected EnRTA (2.8 +/- 0.2). With a 3-day NH4Cl load, the rate of excretion of NH4+ was very low in patients with EnRTA(32 +/- 9 mmol/day), and the relatives with suspected EnRTA also had a decreased capacity to excrete NH4+ (50 +/- 14 mmol/day). In contrast, the normal relatives excreted 92 +/- 12 mmol of NH4/day. The patients with EnRTA could not lower their urine pH to less than 5.5 after the acid loading (6.2 +/- 0.3). After furosemide (20 mg), the NH4+ excretion in the patients with EnRTA was lower than in thenormal relatives. Moreover, the minimum urine pH in patients with EnRTA did not fall(6.1 +/- 0.2), but there was a fall to 4.8 +/- 0.1 in the patients with suspected EnRTA after furosemide treatment. In conclusion, there was a spectrum of tubulointerstitial abnormalities rangingfrom suspected to overt distal RTA in a geographic area known to havea high prevalence of K deficiency. K deficiency might be the important pathogenetic factor of EnRTA in the northeast of Thailand.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 15:10:44