Document Detail

Mechanisms and classification of deranged distal urinary acidification.
MedLine Citation:
PMID:  7446728     Owner:  NLM     Status:  MEDLINE    
Distal renal tubular acidosis has been thought to be the consequence of an impaired ability to maintain a large pH gradient between distal nephron urine and blood. Recent evidence suggests that the classification of deranged distal nephron acidification requires expansion. These mechanisms whereby the urine is acidified in the distal nephron include an active component, a passive component, and a component of bicarbonate secretion. Active proton secretion is influenced by the integrity of the pump and the nature of the electrical chemical gradient against which it operates. The passive component relates either to the backleak of acid from lumen to blood or the leak of bicarbonate from blood to lumen; under ordinary circumstances this passive component is negligible. Aldosterone also influences distal acidification. A defect in most of these components can be identified experimentally. We propose a classification of deranged distal acidification that will allow identification of the mechanism responsible for the defect. This classification, which employs measurement of the urinary carbon dioxide gradient, the response of the kidney to sulfate or phosphate administration, the urinary pH during acidosis, and the state of potassium and sodium excretion, can easily be performed in human subjects.
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 American journal of physiology     Volume:  239     ISSN:  0002-9513     ISO Abbreviation:  Am. J. Physiol.     Publication Date:  1980 Dec 
Date Detail:
Created Date:  1981-02-26     Completed Date:  1981-02-26     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370511     Medline TA:  Am J Physiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  F515-23     Citation Subset:  IM    
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MeSH Terms
Acidosis, Renal Tubular / classification,  urine*
Aldosterone / physiology
Bicarbonates / metabolism
Disease Models, Animal
Electrolytes / metabolism
Hydrogen-Ion Concentration
Kidney Tubules / metabolism*
Kidney Tubules, Distal / metabolism*
Urinary Bladder / metabolism
Grant Support
Reg. No./Substance:
0/Bicarbonates; 0/Electrolytes; 52-39-1/Aldosterone

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

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