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- 1. Etiology and diagnosis of distal (type 1) and proximal (type 2) renal tubular acidosis
- 2. 遠位（I型）および近位（II型）尿細管性アシドーシスの治療 treatment of distal type 1 and proximal type 2 renal tubular acidosis
- 3. 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
- 4. 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
- 5. 尿細管性アシドーシスにおける腎結石症 nephrolithiasis in renal tubular acidosis
- Renal tubular dysfunction in patients with primary Sjögren syndrome.
- Duffles Amarante GB, Zotin MC, Rocha E, Delgado AG, Leite M Jr, Gomes CP.AbstractPrimary Sjögren's syndrome (pSS) is an important cause of renal tubular dysfunction in adults, mainly due to acquired type 1 distal renal tubular acidosis (RTA 1) and concentration defects (CD). This cross-sectional study evaluated renal tubular function of patients with pSS, by detecting proximal tubular injury (through measurements of urinary β2 microglobulin and albumin), RTA 1 (through an acidification protocol using furosemide and fludrocortisone), and CD (through water deprivation test, WDT). A total of 25 patients with pSS were evaluated and despite a preserved renal function (eGFR 92.5 ± 26.3 mL/min/1.73 m2), 24% were diagnosed as RTA 1. On the other hand, CD was diagnosed in 28% of the patients who presented worse renal function (eGFR 68.6 ± 27.7 mL/min/1.73 m2). Increased β2 microglobulin was found in 16% of the patients, and all of them had impaired renal function (eGFR 39.5 ± 11.9 mL/min/1.73 m2). These data showed a high prevalence of tubular dysfunction, mainly RTA 1 and CD, in patients with pSS, and suggest that patients with this disorder should be evaluated by the acidification protocol used in this study and WDT for proper diagnosis. Proximal tubular injury was less common, and probably associated with worsening of renal function.
- Clinical nephrology.Clin Nephrol.2014 Mar;81(3):185-91. doi: 10.5414/CN108142.
- Primary Sjögren's syndrome (pSS) is an important cause of renal tubular dysfunction in adults, mainly due to acquired type 1 distal renal tubular acidosis (RTA 1) and concentration defects (CD). This cross-sectional study evaluated renal tubular function of patients with pSS, by detecting proximal
- PMID 24424087
- Hyponatraemia associated with trimethoprim use.
- Khow KS, Yong TY1.Author information 1Department of General Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia. firstname.lastname@example.org.AbstractTrimethoprim (TMP) is a commonly prescribed antibiotic with few adverse effects. However on rare occasions, TMP is associated with electrolyte disturbances. As seen in our three patients, TMP can be associated with symptomatic hyponatraemia which required hospitalization. In one of these patients, hyperkalaemia and type 4 renal tubular acidosis were also present. These electrolyte and acid-base disorders were corrected after discontinuation of TMP. A small number of patients with TMP-induced electrolyte imbalances have been reported in the English-language medical literature to date but mostly with the use of TMP in combination with sulfamethoxazole. In association with TMP use, hyperkalaemia has been more commonly reported than hyponatraemia. These changes in sodium and potassium balance are thought to be related to TMP inhibiting sodium ion influx via the epithelial sodium channel in the cortical collecting duct. The association between symptomatic hyponatraemia and TMP emphasizes the need to evaluate electrolytes in patients presenting with clinical change after commencing on this drug.
- Current drug safety.Curr Drug Saf.2014 Mar;9(1):79-82.
- Trimethoprim (TMP) is a commonly prescribed antibiotic with few adverse effects. However on rare occasions, TMP is associated with electrolyte disturbances. As seen in our three patients, TMP can be associated with symptomatic hyponatraemia which required hospitalization. In one of these patients, h
- PMID 24372181
- First successful case of simultaneous liver and kidney transplantation for patients with chronic liver and renal failure in Japan.
- Yagi T1, Nobuoka D, Shinoura S, Umeda Y, Sato D, Yoshida R, Utsumi M, Fuji T, Sadamori H, Fujiwara T.Author information 1Hepato-Biliary and Pancreatic Surgery, Okayama University Hospital, Okayama, Japan.AbstractEstablishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have survived for longer than 40 days. The present report describes a case of a 50-year-old woman who had undergone living donor liver transplantation at the age of 38 years for management of post-partum liver failure. After the first transplant surgery, she developed hepatic vein stenosis and severe hypersplenism requiring splenectomy. She was then initiated on hemodialysis (HD) due to the deterioration of renal function after insertion of a hepatic vein stent. She was listed as a candidate for SLK in 2011 because she required frequent plasma exchange for hepatic coma. When her Model for End-stage Liver Disease score reached 46, the new liver was donated 46 days after registration. The reduced trisegment liver and the kidney grafts were simultaneously transplanted under veno-venous bypass and intraoperative HD. The hepatic artery was reconstructed prior to portal reconstruction in order to shorten anhepatic time. Although she developed subcapsular bleeding caused by hepatic contusion on the next day, subsequent hemostasis was obtained by transcatheter embolization. Thereafter, her recovery was uneventful, except for mild rejection and renal tubular acidosis of the kidney graft. This case highlights the need to establish Japanese criteria for SLK.
- Hepatology research : the official journal of the Japan Society of Hepatology.Hepatol Res.2014 Mar;44(3):358-63. doi: 10.1111/hepr.12122. Epub 2013 Apr 29.
- Establishment of a preferential liver allocation rule for simultaneous liver and kidney transplantation (SLK) and revisions of laws regarding organ transplants from deceased donors have paved the way for SLK in Japan. Very few cases of SLK have been attempted in Japan, and no such recipients have su
- PMID 23607507
- 近位尿細管障害を伴った老年者多発性骨髄腫の 1例
- 土井 研人,寺本 信嗣,細井 孝之,宮尾 益理子,松瀬 健,鳥羽 研二,大内 尉義
- 日本老年医学会雑誌 35(6), 477-481, 1998-06-25
- NAID 10008482258
- 大江 厚,金内 雅夫,勝山 慶之,鵜山 秀人,嶋 宏子,藤本 隆,椎木 英夫,土肥 和紘,松岡 弘樹,市島 國雄
- 奈良医学雑誌 49(2), 118-122, 1998-04-30
- … We report a case of diabetic nephropathy and type Ⅳ renal tubular acidosis in a 65-year-old woman. … She was admitted to our hospital because of unstable angina pectoris and was found to have severe metabolic acidosis and hyperkalemia. … Renal biopsy revealed diabetic nephropathy (diffuse Ⅲ) and interstitial fibrosis. …
- NAID 120004973355
- 土井 研人,寺本 信嗣,細井 孝之,宮尾 益理子,松瀬 健,鳥羽 研二,大内 尉義
- 日本老年医学会雑誌 35(6), 477-481, 1998
- … 低γグロブリン血症は改善されなかったが,尿中 free light chain 量は低下しており, 生体内の骨髄腫細胞は減少していると判断した.本症例では, Bence Jones 蛋白による近位尿細管上皮細胞の傷害からII型の尿細管アシドーシスを来したと考えられた. …
- NAID 130003652434
- Main article: proximal renal tubular acidosis. Proximal RTA (pRTA) is caused by a failure of the proximal tubular cells to reabsorb filtered bicarbonate from the urine, leading to urinary bicarbonate wasting ...
- proximal renal tubular acidosis, proximal RTA, pRTA, proximal tubular acidosis
- type 2 renal tubular acidosis, type II renal tubular acidosis, renal tubular acidosis type 2, renal tubular acidosis type II
- type 2 RTA, type II RTA, RTA type 2, RTA type II
HIM -type 2 (proximal). 1744t,1755,1759,1805,1809
- 多発性骨髄腫 → 成人におけるRTA type 2の原因で最多
- 重炭酸が何らかの原因により再吸収されない。 → 高Cl性代謝性アシドーシス
- リン酸、グルコース、尿酸、アミノ酸が再吸収されない。 → 低リン酸血症、腎性糖尿、低尿酸症、アミノ酸尿
- 水・電解質と酸塩基平衡 改訂第2版 p.151
- 血清HCO3-が15mEq/l以下になると再吸収が可能となるので、proximal RTAにおいて血清HCO3-が15-17mEq/l以下になることはまれ。
- 2. [charged] Etiology and diagnosis of distal (type 1) and proximal (type 2) renal tubular acidosis - uptodate 
- 3. [charged] Pathophysiology of renal tubular acidosis and the effect on potassium balance - uptodate 
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- ex. type report_20111118.jp.htm | php a.php > report_20111118.jp.jp.jp.html
- cannular, tubelike, tube-shaped, vasiform