| Distal nephron function in patients receiving chronic lithium therapy. | |
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MedLine Citation:
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PMID: 6283233 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Renal tubular function was studied in 14 patients chronically treated with lithium for affective disorders. Patients were separated into two groups according to the duration of lithium therapy: long-term (35 +/- 7.0 months) and short-term (4.8 +/- 0.8 months). At comparable urine lithium concentrations, patients on long-term therapy had a lower maximal urine osmolality (Umax) and free water reabsorption (TcH2O) than did patients on short-term therapy. The latter group achieved a Umax above 800 mOsm kg H2O. In contrast, both groups of patients failed to increase the urine-blood (U-B) Pco2 gradient normally during acute sodium bicarbonate loading. This low U-B Pco2 was observed at comparable urine bicarbonate concentrations between both groups of patients and controls, and thus was associated with a higher urine pH in patients. These findings indicate that the inability of these patients to achieve a normal U-B Pco2 in a maximally alkaline urine was the result of decreased distal hydrogen ion secretion rather than inability to raise urine bicarbonate concentrations as a result of a concentrating defect. Bicarbonate reabsorptive capacity was normal in our lithium-treated subjects. Both groups of patients achieved a normal U-B Pco2 gradient in response to sodium phosphate loading. They also were able to achieve a minimal urine pH and a maximal acid excretion similar to those of controls in response to a 3-day ammonium chloride loading test. Our data demonstrate that chronic lithium therapy is associated with a mild distal acidification defect disclosed only by the finding of a low U-B Pco2 gradient during sodium bicarbonate loading. This peculiar defect can be found in short-term lithium-treated patients in whom the concentrating capacity is relatively well preserved. |
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Authors:
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D Batlle; M Gaviria; M Grupp; J A Arruda; J Wynn; N A Kurtzman |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Kidney international Volume: 21 ISSN: 0085-2538 ISO Abbreviation: Kidney Int. Publication Date: 1982 Mar |
Date Detail:
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Created Date: 1982-08-14 Completed Date: 1982-08-14 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: GERMANY, WEST |
Other Details:
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Languages: eng Pagination: 477-85 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Ammonium Chloride
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pharmacology Bicarbonates / pharmacology, urine Carbon Dioxide / urine Glomerular Filtration Rate Humans Hydrogen-Ion Concentration Kidney Tubules / physiology* Kidney Tubules, Distal / physiology* Lithium / pharmacology*, therapeutic use* Osmolar Concentration Sodium Bicarbonate Water / physiology Water Deprivation |
| Grant Support | |
ID/Acronym/Agency:
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AM20170/AM/NIADDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Bicarbonates; 12125-02-9/Ammonium Chloride; 124-38-9/Carbon Dioxide; 144-55-8/Sodium Bicarbonate; 7439-93-2/Lithium; 7732-18-5/Water |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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