Syndrome of Incomplete Renal Tubular Acidosis After Cadaver Kidney Transplantation

Renal capacity to excrete acid and lower urinary pH was tested nine patients after cadaver kidney homotransplantation by the short, oral ammonium chloride loading test of Wrong and Davies. The control population consisted of 15 healthy subjects. The patients had a defect in acid excretion resembling incomplete renal tubular acidosis. This defect could not be accounted for by the moderate reduction in glomerular filtration rate. Impaired ability to dilute and concentrate the urine was also shown in the patients. The presence of these abnormalities suggested the occurrence of distal tubular dysfunction in the kidneys transplanted from cadavers. On the basis of these findings it is proposed that the defect in renal acid excretion contributes to the genesis of the metabolic acidosis that occasionally complicates rejection episodes in such patients.