Schaffalitzky de Muckadell O B, Ladefoged J, Thorup J
Scand J Gastroenterol. 1985 Sep;20(7):823-8. doi: 10.3109/00365528509088829.
Renal handling of acid and base was studied in patients with persistent metabolic acidosis 3-9 years after jejunoileal bypass for morbid obesity. Excretion of acid was studied before and after intravenous infusion of NH4Cl and excretion of bicarbonate after infusion of NaHCO3. Bypass patients showed impaired capacity for acidification of urine. The lowest urinary pH was 5.53 +/- 0.10 in 10 bypass patients and 4.76 +/- 0.06 in 6 controls. The corresponding values for standard bicarbonate in plasma were 15.0 +/- 0.3 mM and 15.8 +/- 0.3 mM. Glomerular filtration rate was identical in the two groups. Fractional loss of bicarbonate in urine was higher in controls than in bypass patients. The renal impairment is classified as distal renal tubular acidosis.
对因病态肥胖接受空肠回肠分流术3至9年的持续性代谢性酸中毒患者的肾脏酸碱处理情况进行了研究。在静脉输注氯化铵前后研究了酸的排泄情况，在输注碳酸氢钠后研究了碳酸氢盐的排泄情况。分流术患者表现出尿液酸化能力受损。10例分流术患者的最低尿pH值为5.53±0.10，6例对照组患者为4.76±0.06。血浆中标准碳酸氢盐的相应值分别为15.0±0.3 mM和15.8±0.3 mM。两组的肾小球滤过率相同。对照组尿液中碳酸氢盐的分数丢失高于分流术患者。这种肾脏损害被归类为远端肾小管性酸中毒。
