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TUBULAR FUNCTION IN MEDULLARY CYSTIC DISEASE OF THE KIDNEY
Author(s) -
PAK POY R. K.,
NIALL J. F.
Publication year - 1964
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1964.13.4.334
Subject(s) - renal function , medullary cavity , medicine , excretion , urology , urinary system , reabsorption , kidney , nephrocalcinosis , endocrinology , renal physiology , ammonium chloride , gastroenterology , chemistry , organic chemistry
Summary The urinary acidifying and concentrating mechanisms have been studied in three patients with cysts in the medullary region of the kidney, in association with extensive medullary nephrocalcinosis (Case I), chronic renal failure due to pyelonephritis (Case II) and renal calculi with infection and obstruction relieved by pyeloplasty (Case III). The excretion of ammonium after a loading dose of ammonium chloride was normal in two cases and was reduced in the third case, in which factors other than medullary cysts may have contributed to the defect. Mild impairment of urinary acidification during acid load was demonstrated in two patients with normal ammonia excretion; urinary pH was 5·3 units (glomerular filtration rate 145 ml. per minute) in one patient, a young man (Case I), and 5·6 units (G.F.R. 60 ml. per minute) in another patient, a middle‐aged man (Case II). The maximum reabsorption of solute‐free water, , was normal in all three patients, but the maximum osmotic U/P ratio was significantly reduced in all three patients, indicating a defective concentrating mechanism.