Citrate Excretion in Renal Tubular Acidosis

Case Studies1 January 1963Citrate Excretion in Renal Tubular AcidosisJAMES F. MORRISSEY, M.D., MANUEL OCHOA JR., M.D., WILLIAM D. LOTSPEICH, M.D., CHRISTINE WATERHOUSE, M.D., F.A.C.P.JAMES F. MORRISSEY, M.D.Search for more papers by this author, MANUEL OCHOA JR., M.D.Search for more papers by this author, WILLIAM D. LOTSPEICH, M.D.Search for more papers by this author, CHRISTINE WATERHOUSE, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-1-159 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMetabolic and respiratory acidosis has been shown to decrease the urinary citrate excretion in man (1). Conversely, metabolic or respiratory alkalosis will increase this parameter, without associated increase in the plasma citrate level (2). In these situations, usually the urine pH varies directly with the pH of the blood which does not allow one to differentiate the significance of either factor in the renal excretion of citrate. Recently, Evans, Maclntyre, Macpherson, and Milne (2) have shown that potassium repletion in a patient with primary aldosteronism was associated with an increased urinary citrate excretion. In their case, this occurred in the...References1. CLARKEEVANSMACINTYREMILNE EBMIMD: Acidosis in experimental electrolyte depletion. Clin. Sci. 14: 421, 1955. MedlineGoogle Scholar2. EVANSMACINTYREMACPHERSONMILNE BMICRMD: Alkalosis in sodium and potassium depletion. (With special reference to organic acid excretion.) Clin. Sci. 16: 53, 1957. MedlineGoogle Scholar3. HARRISON HE: Mechanisms of action of vitamin D. Pediatrics 14: 285, 1954. MedlineGoogle Scholar4. BAULDMACDONALDHILL WSSAMC: Effect of renal tubular acidosis on calcium excretion. Brit. J. Urol. 30: 285, 1958. CrossrefMedlineGoogle Scholar5. 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ELKINTONHUTHWEBSTERMCCANCE JREJGDRA: The renal excretion of hydrogen ion in renal tubular acidosis. I. Quantitative assessment of the response to ammonium chloride as an acid load. Amer. J. Med. 29: 554, 1960. CrossrefMedlineGoogle Scholar12. KAYE M: The effect of a single oral dose of the carbonic anhydrase inhibitor acetazoleamide, in renal disease. J. Clin. Invest. 34: 277, 1955. CrossrefMedlineGoogle Scholar13. WEBSTERHUTHELKINTONMCCANCE GDEJJRRA: The renal excretion of hydrogen ion in renal tubular acidosis. II. Quantitative response to the carbonic anhydrase inhibitor, acetazolamide. Amer. J. Med. 29: 576, 1960. CrossrefMedlineGoogle Scholar14. YAFFECRAIGFELLERS SJJMFX: Studies on renal enzymes in a patient with renal tubular acidosis. Amer. J. Med. 29: 168, 1960. CrossrefMedlineGoogle Scholar15. HUTHWEBSTERELKINTON EJGDJR: The renal excretion of hydrogen ion in renal tubular acidosis. III. An attempt to detect latent cases in a family; comments on nosology, genetics and etiology of the primary disease. Amer. J. Med. 29: 586, 1960. CrossrefGoogle Scholar16. BEUTLERYEH EBMK: A simplified method for the determination of citric acid. J. Lab. Clin. Med. 54: 125, 1959. MedlineGoogle Scholar17. REYNOLDS TB: Observations on the pathogenesis of renal tubular acidosis. Amer. J. Med. 25: 503, 1958. CrossrefMedlineGoogle Scholar18. NORDMANNNORDMANN JR: Les acides du cycle tricarboxylique en chimie clinique. Clin. Chem. 3: 462, 1957. MedlineGoogle Scholar19. VISHWAKARMALOTSPEICH PWD: The excretion of 1-malic acid in relation to the tricarboxylic acid cycle in the kidney. J. Clin. Invest. 38: 414, 1959. CrossrefMedlineGoogle Scholar20. MILNESCHRIBNERCRAWFORD MDBHMA: Non-ionic diffusion and the excretion of weak acids and bases. Amer. J. Med. 24: 709, 1958. CrossrefMedlineGoogle Scholar21. STERNOCHOALYNEN JRSF: Enzymatic synthesis of citric acid. V. Reaction of acetyl coenzyme A. J. Biol. Chem. 198: 313, 1952. CrossrefMedlineGoogle Scholar22. WADDELLBUTLER WJTC: Calculation of intracellular pH from the distribution of 5,5-dimethyl-2, 4-oxazolidinedione (DMO). Application to skeletal muscle of the dog. J. Clin. Invest. 38: 720, 1959. CrossrefMedlineGoogle Scholar23. SAMIYOKENREESROBINMERILL AHDSEJP: The renal effects of tris buffer in the dog. Clin. Res. 8: 233, 1960. Google Scholar24. HARRISON HE: The interrelation of citrate and calcium metabolism. Amer. J. Med. 20: 1, 1956. CrossrefMedlineGoogle Scholar25. GORDONSHEPS EESG: Effect of acetazolamide on citrate excretion and formation of renal calculi. Report of a case and study of five normal subjects. New Engl. J. Med. 256: 1215, 1957. CrossrefMedlineGoogle Scholar26. HARRISONHARRISON HEHC: Inhibition of urine citrate excretion and the production of renal calcinosis in the rat by acetazoleamide (Diamox®) administration. J. Clin. Invest. 34: 1662, 1955. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, New YorkFrom the Departments of Medicine and Physiology, University of Rochester School of Medicine and Dentistry, Rochester, New York.Presented in part at the Forty-third Annual Session of the American College of Physicians, Philadelphia, Pennsylvania, April 9-13, 1962.This study was supported by grant OG-22 from the United States Public Health Service. 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ROBERT ARNSTEIN, M.D., BOY FRAME, M.D., F.A.C.P., HAROLD M. FROST, M.D. 1 January 1963Volume 58, Issue 1Page: 159-166KeywordsAttentionBloodBlood plasmaDentistryExcretionMedical servicesPotassiumPotassium chlorideRenal physiologyUrine Issue Published: 1 January 1963 PDF DownloadLoading ...