- Renal tubular acidosis. [Journal Article]
- COCurr Opin Pediatr 2017 Jan 13
- CONCLUSIONS: We briefly update the current information on RTA, put forward the need of additional studies in children to validate urinary indexes used in the diagnosis of RTA and offer a perspective on diagnostic genetic tests.
- Relationship between Urinary Calcium and Bone Mineral Density in Patients with Calcium Nephrolithiasis. [Journal Article]
- JUJ Urol 2017 Jan 04
- CONCLUSIONS: Unlike previous small cross-sectional studies, we found no significant relationship between UCaV and BMD in a large group of calcium KSF. However, a significant inverse relationship was found in E- KSF only. This study suggests that mechanism(s) other than hypercalciuria explain lower BMD and higher fracture risk in patients with KSF, and highlights the role of estrogen on integrity of the bone.
- Successful treatment of renal tubular acidosis and recurrent secondary struvite kidney stones with rituximab in a patient with primary Sjögren's syndrome. [Journal Article]
- RRheumatology (Oxford) 2016 Dec 27
- Complicated pregnancies in inherited distal renal tubular acidosis: importance of acid-base balance. [Journal Article]
- JNJ Nephrol 2016 Dec 22
- Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually pr...
Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually preserved, and hypertension and overt proteinuria are absent, it has to be considered that patients with dRTA also suffer from chronic kidney disease (CKD) with an increased risk for adverse pregnancy-related outcomes. Typical complications of dRTA include severe hypokalemia leading to cardiac arrhythmias and paralysis, nephrolithiasis and nephrocalcinosis. Several physiologic changes occur in normal pregnancy including alterations in acid-base and electrolyte homeostasis as well as in GFR. However, data on pregnancy in women with inherited dRTA are scarce. We report the course of pregnancy in three women with hereditary dRTA. Complications observed were severe metabolic acidosis, profound hypokalemia aggravated by hyperemesis gravidarum, recurrent urinary tract infection (UTI) and ureteric obstruction leading to renal failure. However, the outcome of all five pregnancies (1 pregnancy each for mothers n. 1 and 2; 3 pregnancies for mother n. 3) was excellent due to timely interventions. Our findings highlight the importance of close nephrologic monitoring of women with inherited dRTA during pregnancy. In addition to routine assessment of creatinine and proteinuria, caregivers should especially focus on acid-base status, plasma potassium and urinary tract infections. Patients should be screened for renal obstruction in the case of typical symptoms, UTI or renal failure. Furthermore, genetic identification of the underlying mutation may (a) support early nephrologic referral during pregnancy and a better management of the affected woman, and (b) help to avoid delayed diagnosis and reduce complications in affected newborns.
- Review of the Diagnostic Evaluation of Renal Tubular Acidosis. [Review]
- OJOchsner J 2016; 16(4):525-530
- CONCLUSIONS: RTA is a complex condition that requires thoughtful investigation. Physicians should be aware of the presentation of RTA and the investigative options available to confirm the diagnosis.
- Erratum: A novel heterozygous mutation in the ATP6V0A4 gene encoding the V-ATPase a4 subunit in an adult patient with incomplete distal renal tubular acidosis. [Published Erratum]
- CKClin Kidney J 2016; 9(6):871
- [This corrects the article on p. 424 in vol. 9, PMID: 27274828.].
[This corrects the article on p. 424 in vol. 9, PMID: 27274828.].
- Primary sclerosing cholangitis: a new cause of distal renal tubular acidosis. [Journal Article]
- CKClin Kidney J 2016; 9(6):811-813
- We describe the first case of distal renal tubular acidosis (dRTA) associated with primary sclerosing cholangitis. A 26-year-old Lao-Thai male patient presented with severe jaundice, metabolic acidos...
We describe the first case of distal renal tubular acidosis (dRTA) associated with primary sclerosing cholangitis. A 26-year-old Lao-Thai male patient presented with severe jaundice, metabolic acidosis and hypokalaemia. He was diagnosed of dRTA. Liver transplantation resulted in correction of electrolyte disturbances and hyperbilirubinaemia. A fludrocortisone-furosemide test revealed normal urinary acidification, demonstrating no residual dRTA. This observation suggests that dRTA may be an early manifestation of bilirubin-associated nephropathy or the consequence of an immune mechanism.
- Blood transfusion improves renal oxygenation and renal function in sepsis-induced acute kidney injury in rats. [Journal Article]
- CCCrit Care 2016 Dec 20; 20(1):406
- CONCLUSIONS: Blood transfusion significantly improved renal function in endotoxemic rats. The specific beneficial effect of blood transfusion on the kidney could have been mediated in part by the improvements in renal microvascular oxygenation and sepsis-induced endothelial dysfunction via the restoration of eNOS expression within the kidney.
- Clinical analysis of hyperkalemic renal tubular acidosis caused by calcineurin inhibitors in solid organ transplant recipients. [Case Reports]
- JCJ Clin Pharm Ther 2017; 42(1):122-124
- CONCLUSIONS: We should alert for CNI-induced hyperkalemic RTA in transplant recipients. By CNI dosage reduction or adding low dose fludrocortisone, or temporarily switching to SRL, the prognosis of CNI-induced hyperkalemic RTA is favourable.
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- Acquired Bartter syndrome following gentamicin therapy. [Journal Article]
- IJIndian J Nephrol 2016 Nov-Dec; 26(6):461-463
- Aminoglycoside nephrotoxicity may manifest as nonoliguric renal failure or tubular dysfunction, such as Fanconi-like syndrome, Bartter-like syndrome (BS), or distal renal tubular acidosis. We report ...
Aminoglycoside nephrotoxicity may manifest as nonoliguric renal failure or tubular dysfunction, such as Fanconi-like syndrome, Bartter-like syndrome (BS), or distal renal tubular acidosis. We report a case who developed severe renal tubular dysfunction on the the 7(th) day of gentamicin therapy, resulting in metabolic alkalosis, refractory hypokalemia, hypocalcemia, hypomagnesemia, and polyuria. The patient was diagnosed as a case of transient BS associated with gentamicin exposure. The patient recovered with conservative management.