Short stature, hyperkalemia and acidosis: A defect in renal transport of potassium

Spitzer, Adrian; Edelmann, Jr., Chester M.; Goldberg, Lee D.; Henneman, Philip H.
January 1973
Kidney International;Jan1973, Vol. 3 Issue 1, p251
Academic Journal
An eleven-year-old boy presented with short stature, hyperkalemia. and metabolic acidosis. No endocrine cause for a short stature could be demonstrated. Renal function, as assessed by inulin and PAH clearances, concentrating and diluting capacity, and ability to acidify the urine and lo excrete net acid, was normal. No defect was detected in adrenal secretion of, or renal responsiveness to, aldosterone. A low renal threshold for bicarbonate was documented which apparently explained the acidosis. However, correction of the acidosis by administration of sodium bicarbonate did not influence the hyperkalemia, making it unlikely that an abnormality in bicarbonate reabsorption was the primary defect. Chlorothiazide induced a fall in serum potassium and a rise in serum bicarbonate to normal levels. During bicarbonate loading the rates of excretion of potassium in urine were consistently below those observed in control subjects. It appeared, therefore, that the patient had a primary abnormality in potassium excretion. The resulting hyperkalemia caused urinary loss of bicarbonate and systemic acidosis. Correction of both the acidosis and hyperkalemia by chronic administration of chlorothiazide and sodium bicarbonate has resulted in resumption of normal growth.


Related Articles

  • Site and control of phosphate reabsorption by the kidney. Knox, Franklyn G.; Schneider, Edward G.; Willis, L. R.; Strandhoy, Jack W.; Ott, Cobern E. // Kidney International;Jan1973, Vol. 3 Issue 1, p347 

    Focuses on the site of phosphate reabsorption by the kidney. Relationship between plasma phosphate concentration and the ratio of the clearance of phosphate to the clearance of a glomerular marker; Discussion on the clearance of phosphate and insulin; Demonstration of phosphate secretion in mammals.

  • Use of diuretics in chronic renal failure. Suki, Wadi N. // Kidney International Supplement;Jun1997, Issue 59, pS-33 

    Patients with chronic renal failure retain Na+ and H2O, and they retain K+ and acid. This disordered homeostasis results in hypertension, edema, hyperkalemia and acidosis. Diuretics may be used to favorably modify these disturbances. However, because of the limited filtered load of water and...

  • Plasma.  // Reactions Weekly;Jul2014, Vol. 1509 Issue 1, p28 

    The article presents a case study of an 11-year-old boy who was diagnosed with progressive deterioration of renal function as well as serious urticarial reactions while being medicated with plasma.

  • Effect of acute and chronic metabolic acidosis on serum immunoreactive parathyroid hormone in man. Coe, Fredric L.; Firpo Jr., John J.; Hollandsworth, Don L.; Segil, Laurence; Canterbury, Janet M.; Reiss, Eric // Kidney International;Oct1975, Vol. 8 Issue 4, p262 

    The effects of acute and chronic metabolic acidosis on serum immunoreactive parathyroid hormone (iPTH) were studied. Acute metabolic acidosis induced by administration of ammonium chloride (NH4Cl) produced a barely detectable increase in serum iPTH. Chronic NH4Cl administration produced a marked...

  • Volatile solvent abuse caused glomerulopathy and tubulopathy in street children. Olgar, S.; Oktem, F.; Dindar, A.; Kilbas, A.; Turkoglu, U. D.; Cetin, H.; Altuntas, I.; Yilmaz, R.; Uz, E.; Ertugrul, T.; Omeroglu, R.; Aydogan, U. // Human & Experimental Toxicology;Jun2008, Vol. 27 Issue 6, p477 

    Substance misuse among street children is a significant problem in developing countries. Volatile substances are the most abused agents. According to case reports, chronic renal diseases are common among substance. abusing street children. In this study, we examined the renal findings of 42...

  • Effects of Metabolic Acidosis on Expression Levels of Renal Drug Transporters. Gaowa, Arong; Motohashi, Hideyuki; Katsura, Toshiya; Inui, Ken-ichi // Pharmaceutical Research;May2011, Vol. 28 Issue 5, p1023 

    Purpose: In the renal proximal tubular cells, various transporters play important roles in the secretion and reabsorption of drugs. When metabolic acidosis is induced, a number of adaptive changes occur in the kidney. The purpose of this study was to clarify the changes of drug transporters...

  • Adverse Lipid Effects of HCTZ Are Limited to Nonresponders.  // Kidney;Sep/Oct99, Vol. 8 Issue 5, p198 

    Discusses an abstract of the article, entitled `Diuretics and beta-blockers do not have adverse effects at 1 year on plasma lipid and lipoprotein profiles in men with hypertension,' by M.R. Lakshman, D.J. Reda, B.J. Materson and others, published in the 1999 journal `Archives of Internal Medicine'.

  • Macroprolactin; high molecular mass forms of circulating prolactin. Fahie-Wilson, M N; John, R; Ellis, A R // Annals of Clinical Biochemistry;May2005, Vol. 42 Issue 3, p175 

    Two high molecular mass forms of prolactin (PRL) in serum have been identified by gel filtration chromatography (GFC): macroprolactin (big–big PRL, > 100 kDa) and big PRL (40–60 kDa). Macroprolactin has a variable composition and structure, but is most frequently a complex of PRL...

  • Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post-hoc analysis of a prospective study. Prats, Merche; Font, Ramon; García, Carmen; Cabré, Carmen; Jariod, Manel; Vea, Alberto Martinez // BMC Nephrology;2013, Vol. 14 Issue 1, p1 

    Background: Some parenteral iron therapies have been found to be associated with hypophosphatemia. The mechanism of the decrease in serum phosphate is unknown. The aim of this study is to examine the effect of IV ferric carboxymaltose(FCM) on phosphate metabolism and FGF23 levels in patients...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics