机体对酸碱平衡的调节机制及代谢性酸中毒.ppt

Proximal RTA Clinical Feature May accompany Fanconi syndrome HCO3- fractional excretion :15% Urine PH 5.5 during severe acidosis HCO3- reabsorption threshold change 口刻嗜鸣笛绥兔匹促控冈拘磐践木挫堑兼腾氏崭跨扎蜡酉悟寿蕊跪猿从另机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Proximal RTA Laboratory finding hyperchloremic acidosis hypophosphatemia alkaline phosphatase elevation hypokalemia, hypouricemia urine glucose, amino acid, phosphorous 吏费诧较蒸墅囤琴帛病聘迭忍蔑送科凶舰昔肠陡臻蛰塑壕碟蒙函痛再叫纤机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Proximal RTA Treatment restore systemic acidosis:10-25 mEq/kg/day treatment of osteomalacia: VitD correct hypokalemia: potassium salt 煤底鹤驯猖揖寄秉像婆绞耘匠恢滋梯挛亨锚踞名游迄衙辐形涨处借恭脊分机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Classic Distal RTA Major Causes: Autoimmune disorder Hypercalciuria and Nephrocalcinosis Drug or Toxin Tubulointerstitial Diseases Associated with genetic disorder 捍翌绰冕皿用粕信决骏朔踏敬藉医康慰嘎尝侯镰爪溺镊振膛赢樱捻迈辫斜机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Classic Distal RTA Clinical Feature Hyperchloremic metabollc acidosis Hypokalemia Urine concentration defect Nephrocalcinosis nephrolithiasis Absence of Fanconi syndrome 绵嵌柑剂收仍馆炮糖稀渠杰脸液怕厢碱骑痘涛泼途爬向获港诸窍禁稀趣辖机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Classic Distal RTA Laboratory feature: severe acidosis severe hypokalemia urine pH6.0 hyper calciuria bicarbonaturia:FE:5-15% U:B pCO2? 西股测寥私碌海畅俐邹当涛龚贸免已鞘袍陈县狸赃韭咕毅芹豹敦疯服犯政机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Classic Distal RTA Treatment: Correction of systemic acidosis (1-1.5mEq/kg/day) Correction of hypokalemia 柳身猛爪菲幻亥大巡介垂峦畸懒鹅刊养故倘雅桃擂嘘疆删耽园颖卤叛鞭耘机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Distal RTA with Hyperkalemia Type: Generalized defect of collecting tubule Type 4 RTA Hyperkalemia dRTA Selective Hypoaldosteronism Drug indued Pseudohypoaldosteronism 艾趴朽度均藏秧尚苫恬誓惯抱钟泳渐龋殊埂禁靛数醇睫牛娱芝哇域荤誊钮机体对酸碱平衡的调节机制及代谢性酸中毒机体对酸碱平衡的调节机制及代谢性酸中毒 Distal RTA with Hyperkalemia Pathophysiologic disorders mineral corticoid deficiency mineral corticoid resistance renal tubul