Distal Renal Tubular Acidosis Screening by Urinary Acidification Testing in Mexican Children



Document title: Distal Renal Tubular Acidosis Screening by Urinary Acidification Testing in Mexican Children
Journal: Revista de investigación clínica
Database: PERIÓDICA
System number: 000390711
ISSN: 0034-8376
Authors: 1
1
2
1
3
Institutions: 1Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, México, Distrito Federal. México
2Universidad Nacional Autónoma de México, Facultad de Medicina, México, Distrito Federal. México
3Hospital Universitario Nuestra Señora de la Candelaria, Departamento de Pediatría, Santa Cruz de Tenerife, Canarias. España
Year:
Season: May-Jun
Volumen: 67
Number: 3
Pages: 191-198
Country: México
Language: Inglés
Document type: Artículo
Approach: Aplicado, analítico
English abstract Primary distal renal tubular acidosis is a clinical disorder characterized by hyperchloremic metabolic acidosis, hypercalciuria, hypocitraturia, urinary acidification impairment, hypokalemia, metabolic bone disease, and nephrocalcinosis. Urinary acidification ability may be evaluated by an acidification test or maximum urinary pCO2 assessment with alkaline urine. The maximum urinary pCO2 test using acetazolamide and sodium bicarbonate is an easy test to confirm the lack of urine acidification in distal renal tubular acidosis in children. Objective: To determine the urinary acidification ability using the maximum urinary pCO2 assessment in a group of children with a distal renal tubular acidosis diagnosis. Material and methods: Thirty children were evaluated (13 males and 17 females); 23 children had been diagnosed with distal renal tubular acidosis by other physicians and were under alkali treatment with potassium and sodium citrates (21) and bicarbonate (2), and five children were not under alkali treatment. Two children had been diagnosed with primary distal renal tubular acidosis by our medical group. The maximum urinary pCO2 was determined by the oral intake of acetazolamide and sodium bicarbonate. Results: Two cases with primary distal renal tubular acidosis were found, and they had a history of dehydration episodes during infancy and showed hyperchloremic metabolic acidosis with hypokalemia. They also exhibited urine acidification impairment with furosemide and reduced urinary pCO2 (< 60 mmHg), and the urine-blood pCO2 gradient was reduced in both cases (< 30 mmHg). One of them developed bilateral sensorineural deafness, while the other showed severe hypocitraturia. One case of proximal or type 2 renal tubular acidosis with hyperaminoaciduria was identified. Twenty-eight children displayed normal urinary acidification and did not show signs of distal renal tubular acidosis. Conclusions: The urinary acidification..
Disciplines: Medicina
Keyword: Diagnóstico,
Nefrología,
Acidosis tubular renal,
Nefrocalcinosis,
Acidificación,
Tamizaje,
Pruebas
Keyword: Medicine,
Diagnosis,
Nephrology,
Renal tubular acidosis,
Nephrocalcinosis,
Acidification,
Screening,
Tests
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