Green J, Szylman P, Sznajder I I, Winaver J, Better O S
Arch Intern Med. 1984 Nov;144(11):2201-4.
Renal tubular function, with special emphasis on potassium excretion, was studied in three patients with medullary sponge kidney (MSK). Urinary acidification and concentration abilities were impaired, while glomerular filtration rates remained normal. After short-term intravenous (IV) potassium chloride loading, maximal excretion of potassium was lower in the patients with MSK than in the normal controls. The kaliuretic response to IV sodium sulfate and acetazolamide infusion was maintained. The capacity of the kidney to sustain potassium balance under conditions of either long-term potassium loading or depletion was preserved. We have concluded that the medullary and papillary segments of the human collecting duct, have an important role in the handling of short-term potassium loading. The integrity of these segments, however, is not essential for adaptation to prolonged potassium surfeit or dietary depletion.
对三名髓质海绵肾（MSK）患者的肾小管功能进行了研究，特别关注钾排泄情况。尿酸化和浓缩能力受损，而肾小球滤过率保持正常。短期静脉注射氯化钾负荷后，MSK患者的最大钾排泄量低于正常对照组。对静脉注射硫酸钠和乙酰唑胺输注的促钾利尿反应得以维持。在长期钾负荷或钾缺乏条件下，肾脏维持钾平衡的能力得以保留。我们得出结论，人类集合管的髓质和乳头段在处理短期钾负荷方面具有重要作用。然而，这些段的完整性对于适应长期钾过量或饮食性钾缺乏并非必不可少。
