Renal tubular acidosis of pyelonephritis with renal stone disease.

Cochran, M.; Smith, D. A.; Nordin, B. E. C.

doi:10.1136/bmj.2.5607.721

Cited by 42 publications

(14 citation statements)

References 23 publications

(16 reference statements)

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“…19%, also might be valid for other stone materials. In previously reported materials the frequencies [17][18][19][20] have differed much, which in part may reflect different selection of patient materials as well as different diagnostic criteria. By the method used in this study, information was ob tained of the whole acidification process, not only the urinary pH as in the method described by Wrong and Davies [21].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Clinical Importance of Renal Tubular Defects in Recurrent Renal Stone Formers

Backman

Danielson

Johansson

et al. 1980

Nephron

107

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Renal tubular function was studied in 318 consecutive recurrent renal stone formers. Impaired acidification capacity was found in 19% of the patients, and tubular proteinuria in 13% of the patients. Most of the patients with defective acidification of the urine had the incomplete form of renal tubular acidosis (RTA), proximal and distal defects being equally common. The incidence of impaired acidification was much higher in the female (38%) than in the male (13%) stone formers. A further analysis of the clinical picture in patients with acidification defects revealed a more severe stone disease than among other stone formers. Characteristic findings were an early onset, multiple recurrences with an increased need for surgery. Stone analyses showed a high frequency of calcium phosphate stones. Investigations of renal tubular functions appear to be a valuable adjunct in the evaluation of recurrent renal stone disease.

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Section: Discussionmentioning

confidence: 99%

Incidence and Clinical Importance of Renal Tubular Defects in Recurrent Renal Stone Formers

Backman

Danielson

Johansson

et al. 1980

Nephron

107

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“…C o c h r a n et at. [21] reported a study of 600 subjects with stones utilizing the short NH.iCl test, but did not indicate what percentage of these patients had calcium-containing calculi. From this group, they found 13 patients who did not acidify normally and also described an additional 11 cases from another clinic, all of whom had evidence of pyelonephritis.…”

Section: Discussionmentioning

confidence: 99%

Incomplete Renal Tubular Acidosis: some Clinical and Physiological Features

Tannen

Falls

Brackett³

1975

Nephron

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17 patients with recurrent calcium-containing-renal calculi were studied using the short NH₄CI test and one subject with ‘incomplete renal tubular acidosis’ was identified. In retrospect the only clue to this diagnosis was a fasting, morning urine pH exceeding 6.0 units. Fasting morning urine pH, which is usually less than 6.0 in subjects who acidify normally, is proposed as a simple screening test for ‘incomplete RTA’. Modified high dose NH₄CI tests and Na₂SO₄ tests were performed in this subject and other patients with either complete or incomplete distal renal tubular acidosis. These studies suggest that the ability to lower urine pH is impaired less with the incomplete than with the complete form of the disease.

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“…Initially, only cases of distal renal tubular acidosis were reported but later it was established that the proximal form was also associated with lithiasis (1-4). The incidence of this kind of disturbance varies considerably (3 to 25%) according to the series studied (1)(2)(3)(5)(6)(7)(8). Studies in which both distal and proximal tubules were evaluated have yielded the highest percentages (1,8).…”

Section: Introductionmentioning

confidence: 99%

Study of urinary acidification in patients with idiopathic hypocitraturia

Araújo

Rebelo

2000

Braz J Med Biol Res

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Hypocitraturia (HCit) is one of the most remarkable features of renal tubular acidosis, but an acidification defect is not seen in the majority of hypocitraturic patients, whose disease is denoted idiopathic hypocitraturia. In order to assess the integrity of urinary acidification mechanisms in hypocitraturic idiopathic calcium stone formers, we studied two groups of patients, hypocitraturic (HCit, N = 21, 39.5 ± 11.5 years, 11 females and 10 males) and normocitraturic (NCit, N = 23, 40.2 ± 11.7 years, 16 females and 7 males) subjects, during a short ammonium chloride loading test lasting 8 h. During the baseline period HCit patients showed significantly higher levels of titratable acid (TA). After the administration of ammonium chloride, mean urinary pH (3rd to 8th hour) and TA and ammonium excretion did not differ significantly between groups. Conversely, during the first hour mean urinary pH was lower and TA and ammonium excretion was higher in HCit. The enhanced TA excretion by HCit during the baseline period and during the first hour suggests that the phosphate buffer mechanism is activated. The earlier response in ammonium excretion by HCit further supports other evidence that acidification mechanisms react promptly. The present results suggest that in the course of lithiasic disease, hypocitraturia coexists with subtle changes in the excretion of hydrogen ions in basal situations.

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Renal tubular acidosis of pyelonephritis with renal stone disease.

Cited by 42 publications

References 23 publications

Incidence and Clinical Importance of Renal Tubular Defects in Recurrent Renal Stone Formers

Incidence and Clinical Importance of Renal Tubular Defects in Recurrent Renal Stone Formers

Incomplete Renal Tubular Acidosis: some Clinical and Physiological Features

Study of urinary acidification in patients with idiopathic hypocitraturia

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