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肾小管性酸中毒

[Tubular renal acidosis].

作者信息

Seidowsky A, Moulonguet-Doleris L, Hanslik T, Yattara H, Ayari H, Rouveix E, Massy Z A, Prinseau J

机构信息

Université Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France; Service de médecine interne, hôpital Ambroise-Paré, AP-HP, 92104 Boulogne-Billancourt cedex, France; Service de néphrologie, hôpital Ambroise-Paré, AP-HP, 92104 Boulogne-Billancourt cedex, France.

Service de néphrologie, hôpital Ambroise-Paré, AP-HP, 92104 Boulogne-Billancourt cedex, France.

出版信息

Rev Med Interne. 2014 Jan;35(1):45-55. doi: 10.1016/j.revmed.2013.08.012. Epub 2013 Sep 24.

Abstract

Renal tubular acidosis (RTAs) are a group of metabolic disorders characterized by metabolic acidosis with normal plasma anion gap. There are three main forms of RTA: a proximal RTA called type II and a distal RTA (type I and IV). The RTA type II is a consequence of the inability of the proximal tubule to reabsorb bicarbonate. The distal RTA is associated with the inability to excrete the daily acid load and may be associated with hyperkalaemia (type IV) or hypokalemia (type I). The most common etiology of RTA type IV is the hypoaldosteronism. The RTAs can be complicated by nephrocalcinosis and obstructive nephrolithiasis. Alkalinization is the cornerstone of treatment.

摘要

肾小管酸中毒(RTAs)是一组以代谢性酸中毒伴正常血浆阴离子间隙为特征的代谢紊乱疾病。RTA主要有三种类型:一种近端RTA称为II型,以及远端RTA(I型和IV型)。II型RTA是近端肾小管无法重吸收碳酸氢盐的结果。远端RTA与无法排出每日酸负荷有关,可能与高钾血症(IV型)或低钾血症(I型)相关。IV型RTA最常见的病因是醛固酮缺乏症。RTAs可并发肾钙质沉着症和梗阻性肾结石。碱化是治疗的基石。

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