García Puig J, Mateos Antón F, Martínez Gómez M E, Gil Aguado A, Barbado J, Arnalich F, Montero García A, Vázquez J J
Med Clin (Barc). 1980 Jan 10;74(1):17-23.
The renal plasma flow (RPF), glomerular filtrate (GF), renal concentration strength and urinary acidification capacity in eight patients with alcoholic cirrhosis and five control subjects was studied. The maximum urinary acidification capacity was tested by means or arginine monochloride. In two patients, renal tubular acidosis (RTA) was observed. One patient manifested a slight decrease in RPF, GF, hyposthenuria, hyperchloremic metabolic acidosis and bicarbonaturia. The test for maintained acidification and the overload of bicarbonate indicated a mixed RTA. The other patient manifested incomplete distal RTA, which was briefly corrected with the administration of furosemide. These tubular defects were not associated with the loss of proteins, phosphates, glucose, aminoacids or renal lithiasis. Neither were they related to the serum levels of copper, globulins, or predisposition to hepatic encephalopathy. The association between hepatic cirrhosis and distal tubular acidosis is known, but until the present work, the fact that this hepatopathy can simultaneously affect the proximal and distal tubules had not been described.
对8例酒精性肝硬化患者和5例对照者的肾血浆流量（RPF）、肾小球滤过液（GF）、肾脏浓缩能力和尿液酸化能力进行了研究。通过一氯精氨酸法检测最大尿液酸化能力。在2例患者中观察到肾小管酸中毒（RTA）。1例患者表现为RPF、GF轻度降低，低渗尿、高氯性代谢性酸中毒和碳酸氢盐尿。维持酸化试验和碳酸氢盐负荷试验表明为混合型RTA。另1例患者表现为不完全性远端RTA，给予速尿后短暂纠正。这些肾小管缺陷与蛋白质、磷酸盐、葡萄糖、氨基酸丢失或肾结石无关。它们也与血清铜、球蛋白水平或肝性脑病易感性无关。肝硬化与远端肾小管酸中毒之间的关联是已知的，但在本研究之前，尚未描述这种肝病可同时影响近端和远端肾小管这一事实。
