Studies on acid excretion in adults with sickle-cell anaemia

1. The acid excretion of patients with sickle-cell anaemia has been studied.

2. There is a mild defect in urinary acidification and a decreased H+ excretion in response to ammonium chloride loading.

3. The acidification defect was not corrected by oral administration of a phosphate solution.

4. Infusion of a sodium sulphate solution in subjects who were avidly reabsorbing sodium produced equal degrees of urine acidification in patients and controls.

5. Studies on bicarbonate reabsorption were inconclusive.

6. We conclude that patients with sickle-cell anaemia have a mild form of incomplete distal renal tubular acidosis.

Acid-base status of adults with sickle-cell anaemia

Determinations of the acid-base status of 10 adult Jamaican patients with sickle-cell anaemia during "painful crisis" and after recovery showed no evidence of metabolic acidosis in the former, in contrast to reports from elsewhere. These results could explain the failure of alkalis to abort or alter the acute painful episodes of most patients with sickle-cell anaemia.