镰状细胞性状中的肾脏酸化作用。

Renal acidification in sickle cell trait.

作者信息

Oster J R, Lee S M, Lespier L E, Pellegrini E L, Vaamonde C A

出版信息

Arch Intern Med. 1976 Jan;136(1):30-5.

Abstract

Nine sickle cell trait and nine control subjects underwent six-hour ammonium chloride acid loading. Maximal urine osmolality and renal hemodynamics were studied separately. Base line arterial pH, carbon dioxide pressure (Pco2), and [HCO3] were normal and comparable in the two groups. After ammonium chloride loading, urine pH decreased to 5.3 or less in all, and maximal excretion of ammonium and titratable and net acid was comparable as was urine minus blood Pco2 after bicarbonate loading. The ammonium chloride acidosis caused a small decrease in red blood cell 2,3-diphosphoglycerate levels but no alteration in oxygen pressure at 50% saturation at pH 7.4, sickling, or adverse effects. Control and sickle cell trait subjects had comparable renal hemodynamics but maximal urine osmolality was lower in sickle-cell trait subjects. Adults with sickle cell trait have diminished renal concentrating ability and normal renal acidification and hemodynamics.

摘要

9名镰状细胞性状携带者和9名对照受试者接受了为期6小时的氯化铵酸负荷试验。分别对最大尿渗透压和肾血流动力学进行了研究。两组的基线动脉pH值、二氧化碳分压（Pco2）和[HCO3]均正常且具有可比性。氯化铵负荷后，所有人的尿液pH值均降至5.3或更低，铵、可滴定酸和净酸的最大排泄量相当，碳酸氢盐负荷后尿液减去血液Pco2的值也相当。氯化铵酸中毒导致红细胞2,3-二磷酸甘油酸水平略有下降，但在pH 7.4时50%饱和度下的氧分压、镰状化或不良反应均无改变。对照和镰状细胞性状受试者的肾血流动力学相当，但镰状细胞性状受试者的最大尿渗透压较低。患有镰状细胞性状的成年人肾浓缩能力减弱，但肾酸化和血流动力学正常。