双侧髓质海绵肾女性的尿液酸化及钙和柠檬酸盐的尿排泄情况

Urinary acidification and urinary excretion of calcium and citrate in women with bilateral medullary sponge kidney.

作者信息

Osther P J, Mathiasen H, Hansen A B, Nissen H M

机构信息

Department of Urology, University Hospital, Odense, Denmark.

出版信息

Urol Int. 1994;52(3):126-30. doi: 10.1159/000282590.

DOI:10.1159/000282590

PMID:8203049

Abstract

Urinary acidification ability, acid-base status and urinary excretion of calcium and citrate were evaluated in 10 women with bilateral medullary sponge kidney (MSK) and in 10 healthy women. Patients with MSK had higher fasting urine pH compared to normal controls (p < 0.01). Four patients had incomplete renal tubular acidiosis (iRTA), 3 had hypercalciuria, and 5 patients had hypocitraturia. The 24-hour urinary excretion of calcium was increased in the females with MSK (5.23 +/- 0.78 mmol) compared to the healthy females (3.49 +/- 0.29 mmol) (p < 0.02), and increased in MSK patients with iRTA (7.32 +/- 1.45 mmol) compared to patients with normal urinary acidification (3.83 +/- 0.12 mmol) (p < 0.01). The patients with iRTA had reduced levels of plasma standard bicarbonate (20.5 +/- 1.0) after fasting compared to patients with normal urinary acidification (23.8 +/- 0.8) and healthy women (22.7 +/- 0.6) (p < 0.01), and reduced levels of 24-hour urinary excretion of citrate (0.93 +/- 0.25 mmol) compared to patients with normal urinary acidification (3.58 +/- 0.51) and healthy women (2.78 +/- 0.49) (p < 0.005). A positive correlation was found between the degree of acidosis during ammonium chloride loading and urinary excretion of calcium (r = 0.71, p = 0.02), and a negative correlation between the degree of acidosis during ammonium chloride loading and urinary citrate excretion (r = 0.87, p = 0.001). The results suggest that defective urinary acidification might play an important role in the mechanism of hypercalciuria and hypocitraturia in patients with medullary sponge kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对10例双侧髓质海绵肾（MSK）女性患者和10例健康女性的尿液酸化能力、酸碱状态以及钙和柠檬酸盐的尿排泄情况进行了评估。与正常对照组相比，MSK患者的空腹尿pH值更高（p < 0.01）。4例患者患有不完全肾小管性酸中毒（iRTA），3例有高钙尿症，5例有低枸橼酸尿症。与健康女性（3.49±0.29 mmol）相比，MSK女性患者的24小时尿钙排泄量增加（5.23±0.78 mmol）（p < 0.02），与尿液酸化正常的患者（3.83±0.12 mmol）相比，iRTA的MSK患者尿钙排泄量增加（7.32±1.45 mmol）（p < 0.01）。与尿液酸化正常的患者（23.8±0.8）和健康女性（22.7±0.6）相比，iRTA患者空腹后血浆标准碳酸氢盐水平降低（20.5±1.0）（p < 0.01），与尿液酸化正常的患者（3.58±0.51）和健康女性（2.78±0.49）相比，24小时尿柠檬酸盐排泄量降低（0.93±0.25 mmol）（p < 0.005）。氯化铵负荷试验期间的酸中毒程度与尿钙排泄之间呈正相关（r = 0.71，p = 0.02），与尿柠檬酸盐排泄呈负相关（r = 0.87，p = 0.001）。结果表明，尿液酸化缺陷可能在髓质海绵肾患者高钙尿症和低枸橼酸尿症的机制中起重要作用。（摘要截选至250字）