Conte G, Dal Canton A, Marcuccio F, Stanziale P, Andreucci V E
Arch Intern Med. 1986 Sep;146(9):1814-6.
In a patient with renal amyloidosis secondary to chronic urinary tract infection with nephrotic syndrome, polyuric acute renal failure developed after reduction from a high to a normal dietary intake of sodium and was reversed by salt replacement therapy. As documented by functional and morphological studies, the patient had a marked defect of tubular sodium reabsorption at the proximal site and along the ascending limb of Henle's loop, a distal tubular unresponsiveness to aldosterone, and severe tubulointerstitial damage in the medulla. We propose that the sodium dietary reduction in conjunction with severe tubular dysfunction and hypovolemia due to nephrotic syndrome is responsible for this unused form of polyuric acute prerenal failure.
在一名继发于慢性尿路感染并伴有肾病综合征的肾淀粉样变性患者中，在从高钠饮食降至正常钠饮食后出现了多尿性急性肾衰竭，而补充盐分治疗使其逆转。功能和形态学研究表明，该患者近端肾小管及亨氏袢升支存在明显的钠重吸收缺陷，远端肾小管对醛固酮无反应，且髓质存在严重的肾小管间质损伤。我们认为，由于肾病综合征导致的钠饮食减少、严重肾小管功能障碍和血容量不足，是这种罕见形式的多尿性急性肾前性肾衰竭的病因。
