51
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Norman ME, Feldman NI, Cohn RM, Roth KS, McCurdy DK. Urinary citrate excretion in the diagnosis of distal renal tubular acidosis. J Pediatr 1978; 92:394-400. [PMID: 632978 DOI: 10.1016/s0022-3476(78)80426-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Since hypocitraturia in distal renal tubular acidosis, we screened the asymptomatic children in three families with familial dRTA, by comparing their 24-hour urine citrate excretion to values obtained in 45 normal children. Subsequent acid loading uncovered four new cases of dRTA suspected because of the finding of hypocitraturia. Because hypocitraturia probably contributes to nephrolithiasis/nephrocalcinosis and subsequent renal damage in dRTA, affected family members were treated with alkali (4 mEq/kg/day), which normalized urine citrate in three children; in a fourth child citrate excretion rose but was not normal. Measurement of urine citrate excretion was superior to other currently proposed screening tests for dRTA (first morning urine pH and sediment, urine concentration).
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52
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Schloeder FX, Stinebaugh BJ. Urinary ammonia content as a determinant or urinary pH during chronic metabolic acidosis. Metabolism 1977; 26:1321-31. [PMID: 22017 DOI: 10.1016/0026-0495(77)90028-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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53
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Sebastian A, Schambelan M, Lindenfeld S, Morris RC. Amelioration of metabolic acidosis with fludrocortisone therapy in hyporeninemic hypoaldosteronism. N Engl J Med 1977; 297:576-83. [PMID: 18672 DOI: 10.1056/nejm197709152971104] [Citation(s) in RCA: 111] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In four patients with renal hyperchloremic acidosis and hyperkalemia, hyporeninemic hypoaldosteronism and chronic renal insufficiency (glomerular filtration rates of 13, 31, 35 and 44 ml per minute per 1.73 m2), prolonged administration of fludrocortisone increased urinary potassium and net acid excretion, corrected hyperkalemia and substantially ameliorated acidosis. Except in the patient with the lowest glomerular filtration rate, the increased net acid excretion was due mostly to increased ammonium excretion. Urine pH decreased initially in each patient, but in the three patients with the highest filtration rates, it increased subsequently as ammonium excretion increased, indicating that renal ammonia production increased. Urinary ammonium excretion correlated inversely with serum potassium concentration and did not decrease on discontinuation of therapy if hyperkalemia was prevented from recurring. In patients with renal acidosis and hyporeninemic hypoaldosteronism, administration of mineralocorticoid hormone can augment both renal hydrogen-ion secretion and, by correction of hyperkalemia, renal ammonia production, and thereby ameliorate metabolic acidosis.
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54
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55
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Palmer RH, Cornfeld D. Primary renal tubular acidosis recognized and treated at three days of age. A case report illustrating the value of routine postmortem examination. Clin Pediatr (Phila) 1973; 12:140-4. [PMID: 4701463 DOI: 10.1177/000992287301200307] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Renal tubular acidosis should be suspected even in the very young in fant who does not thrive, and who demonstrates a hyperchloremic acidosis with urine of neutral pH. This case report details the course of an infant whose disease was diagnosed in the newborn nursery.
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MESH Headings
- Acidosis, Renal Tubular/complications
- Acidosis, Renal Tubular/diagnosis
- Acidosis, Renal Tubular/drug therapy
- Acidosis, Renal Tubular/genetics
- Acidosis, Renal Tubular/pathology
- Ammonium Chloride
- Autopsy
- Blood Urea Nitrogen
- Citrates/therapeutic use
- Creatinine/blood
- Female
- Growth Disorders/etiology
- Humans
- Hydrogen-Ion Concentration
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/drug therapy
- Kidney Tubules/pathology
- Nephrocalcinosis/pathology
- Phosphates/urine
- Potassium/urine
- Quaternary Ammonium Compounds/urine
- Sodium/urine
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56
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Free AH, Free HM. Urinalysis, critical discipline of clinical science. CRC CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 1972; 3:481-531. [PMID: 4618181 DOI: 10.3109/10408367209151553] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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57
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Arcila H, Chávez de los Ríos J, Van Dyck R, Zorrilla E. Hypercalcaemia, hypophosphataemia, and inability to excrete hydrogen ions. BRITISH MEDICAL JOURNAL 1972; 4:400-3. [PMID: 4637153 PMCID: PMC1786635 DOI: 10.1136/bmj.4.5837.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Investigation of a patient with hypercalcaemia, hypophosphataemia, and nephrocalcinosis failed to lead to a clear diagnosis. Neither primary hyperparathyroidism nor primary incomplete renal tubular acidosis could explain all the biochemical features, and it seems that more than one fundamental abnormality may have been present.
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58
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Hadler NM, Gill JR, Gardner JD. Impaired renal tubular secretion of potassium, elevated sweat sodium chloride concentration and plasma inhibition of erythrocyte sodium outflux as complications of systemic lupus erythematosus. ARTHRITIS AND RHEUMATISM 1972; 15:515-23. [PMID: 4634804 DOI: 10.1002/art.1780150507] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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59
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McSherry E, Sebastian A, Morris RC. Renal tubular acidosis in infants: the several kinds, including bicarbonate-wasting, classic renal tubular acidosis. J Clin Invest 1972; 51:499-514. [PMID: 5011097 PMCID: PMC302155 DOI: 10.1172/jci106838] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
In four infants with renal tubular acidosis (RTA), including three with apparently classic RTA and one with Fanconi syndrome (FS), the physiologic character of the renal acidification defect was investigated. In two of the infants with apparently classic RTA, the acidification defect was physiologically separable from that described in both adult patients and children with classic RTA (type 1 RTA) in the following ways. (a) The fractional excretion of filtered bicarbonate (C(HCO3)/C(ln)) was not trivial but substantial (6-9%), as well as relatively fixed, over a broad range of plasma bicarbonate concentrations (15-26 mmoles/liter). (b) This value of C(HCO3)/C(ln), combined with a normal or near normal glomerular filtration rate, translated to renal bicarbonate wasting (RBW). (c) RBW at normal plasma bicarbonate concentrations was the major cause of acidosis, and its magnitude was the major determinant of corrective alkali therapy (5-9 mEq/kg per day), just as in the patient with FS, who was found to have type 2 ("proximal") RTA. (d) Persistence of RBW at substantially reduced plasma bicarbonate concentrations, which did not occur in FS, accounted for the spontaneous occurrence of severe acidosis and its rapid recurrence after reduction in alkali therapy. (e) During severe acidosis the urinary pH was >7, a finding reported frequently in infants with apparently classic RTA and "alkali-resistant" acidosis but rarely in adult patients with classic RTA. Continued supplements of potassium were required to maintain normokalemia during sustained correction of acidosis with alkali therapy. Yet, in at least two of the three infants with apparently classic RTA, but in distinction from the patient with FS and other patients with type 2 RTA, fractional excretion of filtered potassium decreased when plasma bicarbonate was experimentally increased to normal values. In one of the two infants with apparently classic RTA and RBW, C(HCO3)/C(ln) and the therapeutic alkali requirement decreased concomitantly and progressively over 2 yr, but RBW continued. Renal tubular acidosis has persisted in all four patients for at least 3 yr, and in three for 4 years.
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60
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Bridi GS, Falcon PW, Brackett NC, Still WJ, Sporn IN. Glomerulonephritis and renal tubular acidosis in a case of chronic active hepatitis with hyperimmunoglobulinemia. Am J Med 1972; 52:267-78. [PMID: 5058508 DOI: 10.1016/0002-9343(72)90075-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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61
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Berg U, Aperia A, Broberger O. Subclinical defects in renal regulation of acid base balance in children with recurrent urinary tract infections. ACTA PAEDIATRICA SCANDINAVICA 1971; 60:521-7. [PMID: 5110534 DOI: 10.1111/j.1651-2227.1971.tb06984.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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62
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Rodriguez-Soriano J. The renal regulation of acid-base balance and the disturbances noted in renal tubular acidosis. Pediatr Clin North Am 1971; 18:529-45. [PMID: 4939563 DOI: 10.1016/s0031-3955(16)32564-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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63
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Donckerwolcke RA, van Stekelenburg GJ, Tiddens HA. A case of bicarbonate-losing renal tubular acidosis with defective carboanhydrase activity. Arch Dis Child 1970; 45:769-73. [PMID: 4992595 PMCID: PMC1647400 DOI: 10.1136/adc.45.244.769] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
A girl of 20 months had primary proximal renal tubular acidosis with a lowered renal threshold for bicarbonate. There was no carboanhydrase inhibition after acetazolamide administration, suggesting that defective carboanhydrase activity may have been causative.
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64
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Guignard JP, Peters G. Effects of triamterene and amiloride on urinary acidification and potassium excretion in the rat. Eur J Pharmacol 1970; 10:255-67. [PMID: 5446379 DOI: 10.1016/0014-2999(70)90281-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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65
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Liebau G, Müller R, Schad H, Edel HH. [Proximal tubular acidosis in patients with kidney transplants]. KLINISCHE WOCHENSCHRIFT 1970; 48:624-9. [PMID: 4932876 DOI: 10.1007/bf01485397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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66
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van der Zee SP, Lommen EJ, Trijbels JM, Schretlen ED. The influence of adenine on the clinical features and purine metabolism in the Lesch-Nyhan syndrome. ACTA PAEDIATRICA SCANDINAVICA 1970; 59:259-64. [PMID: 5444710 DOI: 10.1111/j.1651-2227.1970.tb09001.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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67
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68
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Sutherland LE, Hartroft P, Balis JU, Bailey JD, Lynch MJ. Bartter's syndrome. A report of four cases, including three in one sibship, with comparative histologic evaluation of the juxtaglomerular apparatuses and glomeruli. ACTA PAEDIATRICA SCANDINAVICA. SUPPLEMENT 1970; 201:Suppl 201:1+. [PMID: 4317710 DOI: 10.1111/j.1651-2227.1970.tb06125.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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69
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Dalton RG, Phillips GD. Renal function in neonatal calves: response to acidosis. THE BRITISH VETERINARY JOURNAL 1969; 125:367-78. [PMID: 5806881 DOI: 10.1016/s0007-1935(17)48807-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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70
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Davies JE, Tocci PM. Renal tubular dysfunction and amino acid disturbances under conditions of pesticide exposure. Ann N Y Acad Sci 1969; 160:323-33. [PMID: 5257400 DOI: 10.1111/j.1749-6632.1969.tb15852.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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71
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Shear L, Bonkowsky HL, Gabuzda GJ. Renal tubular acidosis in cirrhosis. A determinant of susceptibility to recurrent hepatic precoma. N Engl J Med 1969; 280:1-7. [PMID: 5761704 DOI: 10.1056/nejm196901022800101] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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72
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Györy AZ, Negrin A, Edwards KD. Urinary excretion of titratable acid and its relationship to urinary pH and inorganic phosphorus excretion. AUSTRALASIAN ANNALS OF MEDICINE 1968; 17:236-41. [PMID: 5684609 DOI: 10.1111/imj.1968.17.3.236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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73
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Györy AZ, Edwards KD. Renal tubular acidosis. A family with an autosomal dominant genetic defect in renal hydrogen ion transport, with proximal tubular and collecting duct dysfunction and increased metabolism of citrate and ammonia. Am J Med 1968; 45:43-62. [PMID: 5658868 DOI: 10.1016/0002-9343(68)90006-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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74
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Buckalew VM, McCurdy DK, Ludwig GD, Chaykin LB, Elkinton JR. Incomplete renal tubular acidosis. Physiologic studies in three patients with a defect in lowering urine pH. Am J Med 1968; 45:32-42. [PMID: 5658867 DOI: 10.1016/0002-9343(68)90005-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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75
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Litvak J, Contreras V, Oberhauser E, Armendaris R, Alliende I. Acquired nonfamilial osteomalaci. Factors in pathogenesis and the results of long-term treatment with oral phosphate. Am J Med 1968; 44:474-82. [PMID: 5641307 DOI: 10.1016/0002-9343(68)90118-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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76
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77
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Wilson ID, Williams RC, Tobian L. Renal tubular acidosis. Three cases with immunoglobulin abnormalities in the patients and their kindreds. Am J Med 1967; 43:356-70. [PMID: 4166917 DOI: 10.1016/0002-9343(67)90192-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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78
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Levine AS, Michael AF. Ehlers-Danlos syndrome with renal tubular acidosis and medullary sponge kidneys. A report of a case and studies of renal acidification in other patients with the Ehlers-Danlos syndrome. J Pediatr 1967; 71:107-13. [PMID: 5293846 DOI: 10.1016/s0022-3476(67)80238-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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79
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Rieselbach RE, Klahr S, Bricker NS. Diffuse bilateral cortical necrosis; a longitudinal study of the functional characteristics of residual nephrons. Am J Med 1967; 42:457-68. [PMID: 6018862 DOI: 10.1016/0002-9343(67)90274-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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80
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Massry SG, Preuss HG, Maher JF, Schreiner GE. Renal tubular acidosis after cadaver kidney homotransplantation. Studies on mechanism. Am J Med 1967; 42:284-92. [PMID: 5335111 DOI: 10.1016/0002-9343(67)90026-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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81
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Greenberg AJ, McNamara H, McCrory WW. Metabolic balance studies in primary renal tubular acidosis: effects of acidosis on external calcium and phosphorus balances. J Pediatr 1966; 69:610-8. [PMID: 5921337 DOI: 10.1016/s0022-3476(66)80048-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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82
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83
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84
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Chemical pathology in relation to clinical medicine RENAL FUNCTION: The proceedings of a symposium organized by the Association of Clinical Pathologists held in London at the Westminster Hospital 16-17 October 1964. Clin Mol Pathol 1965; 18:491-578. [PMID: 16811025 PMCID: PMC473000 DOI: 10.1136/jcp.18.4.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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85
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86
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87
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88
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89
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BLOOMER HA, CANARY JJ, KYLE LH, AULD RM. The Fanconi syndrome with renal hyperchloremic acidosis. Sequential development of multiple tubular dysfunctions in a child. Am J Med 1962; 33:141-9. [PMID: 13870148 DOI: 10.1016/0002-9343(62)90283-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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90
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91
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92
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93
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WEBSTER GD, HUTH EJ, ELKINTON JR, McCANCE RA. The renal excretion of hydrogen ion in renal tubular acidosis. II. Quantitative response to the carbonic anhydrase inhibitor, acetazolamide. Am J Med 1960; 29:576-85. [PMID: 13783654 DOI: 10.1016/0002-9343(60)90091-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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