Effect of Mersalyl, Ethacrynic Acid and Sodium Sulphate Infusion on Urinary Acidification in Hereditary Renal Tubular Acidosis

Normal minimum urinary pH values could be induced in three asymptomatic members of a family with inherited renal tubular acidosis by treatment with mersalyl given Intramuscularly, ethacrynic acid given by mouth or sodium sulphate given by intravenous infusion. Ethacrynic acid tried in a symptomatic member of the same family was ineffective in producing a normal minimum urinary pH, but the pH reached was the lowest ever recorded from this patient. The possible mechanisms involved are discussed, and it is proposed that abnormally high permeability to hydrogen ions, allowing increased back diffusion, may exist in the collecting ducts in patients with inherited renal tubular acidosis.