Document Detail

Hyperkalemic distal renal tubular acidosis associated with obstructive uropathy.
MedLine Citation:
PMID:  7453754     Owner:  NLM     Status:  MEDLINE    
We studied renal function in 13 patients with obstructive uropathy and hyperkalemic metabolic acidosis to characterize the pathogenesis of this disorder. Base-line fractional potassium excretion was lower in all patients than in controls with similar glomerular filtration rates. Acetazolamide was given to 11 patients but failed to increase fractional potassium excretion to normal. In five patients, impaired potassium excretion was associated with decreased ammonium excretion, a urinary pH below 5.5 (5.18 +/- 0.07, mean +/- S.E.M.), and aldosterone deficiency. In the remaining eight patients, the urinary pH did not fall below 5.5 (6.4 +/- 0.2) with acidosis, and we failed to lower the urinary pH and increase fractional potassium excretion to normal by administering a mineralocorticoid and sodium sulfate. A syndrome of hyperkalemic distal renal tubular acidosis may occur in patients with obstructive uropathy. In some patients, this syndrome results from a defect in hydrogen and potassium secretion in the distal nephron rather than from aldosterone deficiency. Obstructive uropathy should be included in the differential diagnosis of hyperkalemic acidosis and renal insufficiency.
D C Batlle; J A Arruda; N A Kurtzman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  304     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1981 Feb 
Date Detail:
Created Date:  1981-03-17     Completed Date:  1981-03-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  373-80     Citation Subset:  AIM; IM    
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MeSH Terms
Acetazolamide / therapeutic use
Acidosis, Renal Tubular / diagnosis,  etiology*,  physiopathology
Aldosterone / blood
Diagnosis, Differential
Glomerular Filtration Rate
Hyperkalemia / drug therapy,  etiology*
Kidney / physiopathology
Kidney Tubules, Distal / physiopathology
Middle Aged
Mineralocorticoids / therapeutic use
Potassium / urine
Urologic Diseases / complications*
Grant Support
Reg. No./Substance:
0/Mineralocorticoids; 52-39-1/Aldosterone; 59-66-5/Acetazolamide; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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