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1. 腎尿細管性アシドーシスの概要と病態生理、およびカリウムバランスへの影響 overview and pathophysiology of renal tubular acidosis and the effect on potassium balance
2. 慢性腎臓病における代謝性アシドーシスの病因、影響、および治療 pathogenesis consequences and treatment of metabolic acidosis in chronic kidney disease
3. 成人における代謝性アシドーシスへのアプローチ approach to the adult with metabolic acidosis
4. 遠位（I型）および近位（II型）尿細管性アシドーシスの病因および診断 etiology and diagnosis of distal type 1 and proximal type 2 renal tubular acidosis
5. 幼児および小児における尿細管性アシドーシスの病因および臨床症状 etiology and clinical manifestations of renal tubular acidosis in infants and children

English Journal

Isotonic crystalloid solutions: a structured review of the literature.

Orbegozo Cortés D1, Rayo Bonor A, Vincent JL.Author information 1Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.AbstractBACKGROUND: /st>Several different crystalloid solutions are available for i.v. fluid administration but there is little information about their specific advantages and disadvantages.
British journal of anaesthesia.Br J Anaesth.2014 Apr 15. [Epub ahead of print]
BACKGROUND: /st>Several different crystalloid solutions are available for i.v. fluid administration but there is little information about their specific advantages and disadvantages.METHODS: /st>We performed a systematic search of MEDLINE, EMBASE, and CENTRAL up until May 17, 2012, selecting a
PMID 24736393

Should chloride-rich crystalloids remain the mainstay of fluid resuscitation to prevent 'pre-renal' acute kidney injury?: con.

Lobo DN, Awad S.Author information Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute of Health Research Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK.AbstractThe high chloride content of 0.9% saline leads to adverse pathophysiological effects in both animals and healthy human volunteers, changes not seen after balanced crystalloids. Small randomized trials confirm that the hyperchloremic acidosis induced by saline also occurs in patients, but no clinical outcome benefit was demonstrable when compared with balanced crystalloids, perhaps due to a type II error. A strong signal is emerging from recent large propensity-matched and cohort studies for the adverse effects that 0.9% saline has on the clinical outcome in surgical and critically ill patients when compared with balanced crystalloids. Major complications are the increased incidence of acute kidney injury and the need for renal replacement therapy, and that pathological hyperchloremia may increase postoperative mortality. However, there are no large-scale randomized trials comparing 0.9% saline with balanced crystalloids. Some balanced crystalloids are hypo-osmolar and may not be suitable for neurosurgical patients because of their propensity to cause brain edema. Saline may be the solution of choice used for the resuscitation of patients with alkalosis and hypochloremia. Nevertheless, there is evidence to suggest that balanced crystalloids cause less detriment to renal function than 0.9% saline, with perhaps better clinical outcome. Hence, we argue that chloride-rich crystalloids such as 0.9% saline should be replaced with balanced crystalloids as the mainstay of fluid resuscitation to prevent 'pre-renal' acute kidney injury.Kidney International advance online publication, 9 April 2014; doi:10.1038/ki.2014.105.
Kidney international.Kidney Int.2014 Apr 9. doi: 10.1038/ki.2014.105. [Epub ahead of print]
The high chloride content of 0.9% saline leads to adverse pathophysiological effects in both animals and healthy human volunteers, changes not seen after balanced crystalloids. Small randomized trials confirm that the hyperchloremic acidosis induced by saline also occurs in patients, but no clinical
PMID 24717302