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| 원위부 신세뇨관성 산성증 ( Type 1 PTA ) 1예 |
| 박원근 , 오정균 , 양인명 , 조경삼 , 최영길 , 김명재 |
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| Abstract |
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Distal, also referred to as type 1, classic, or gra- dient, RTA is a disturbance characterized by impai- red secretion of H' in the collecting duct and cons- equent inability to establish the normally steep H' gradient between blood and urine. Therefore, the urine pH will be inappropriately high even under conditions of acidosis. Authors recently had a chance to examine a 50 years old famale patient who was admitted to the Kyung Hee Uiversity Hospital because of periodic paralysis, thirst and generalized weakness. The patient presented with hypokalemia, decreased serum biocarbonate, increased serum chloride, ina- bility of urinary concentration and acidification and potassium depleting nephropathy. Authors studied ammonium chloride loading test and bicarbonate loading test for differentiation between proximal and distal RTA. In the ammonium chloride loading test, This case remained unchanged urinap pH and urine contained bicarbonate even during sevete degree of acidosis (plasma bicarborate 14.6 mM/1). U-BPCO, was ineasured 13. 6 mmHg in the bicarbonate loading test. The results suggested distal RTA. The patient was subsequently treated by a mixture of potassium and sodium bicarbonate with good response. |
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