尿細管性アシドーシス不完全型の2例—結石治療についての考察

TWO CASES OF INCOMPLETE RENAL TUBULAR ACIDOSIS (RTA):SOME CONSIDERATIONS ON STONE PREVENTIVE THERAPY

緒言

　遠位型腎尿細管性アシドーシス（以下RTA）は，高頻度に腎石灰化症および腎結石を合併する。

　われわれは，不完全型RTAの2例を経験したが，1例では腎結石の治療としてアルカリ化剤（重曹）を投与したところ，結石の急速な増大をみた。本疾患にアルカリ化剤を投与することは，結石の発生や増大を助長する可能性もあり，この点について考察を加える。

A defect in ability to lower urine pH in response to ammonium chloride loading in the absence of systemic acidosis is defined as the syndrome of incomplete renal tubular acidosis. Two patients were described who had urinary calculus in association with incomplete RTA. The first patient visited our hospital for investigation of the cause of recurrent urinary calculi. She had nephrolithiasis with hyper-calciuria in the absence of systemic acidosis. It was found that she had a defect in ability to lower urine pH in response to long ammonium chloride loading.