酸碱平衡的调节与代酸.ppt

Proximal RTA Clinical Feature May accompany Fanconi syndrome HCO3- fractional excretion :15% Urine PH 5.5 during severe acidosis HCO3- reabsorption threshold change 广吠眩眷芦然证庄捌凄搀舌蔡义帆搁疏屯良怒晃栏处区掏铸发奥惭滥盾攘酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Proximal RTA Laboratory finding hyperchloremic acidosis hypophosphatemia alkaline phosphatase elevation hypokalemia, hypouricemia urine glucose, amino acid, phosphorous 责却家弯疑孔屡脾喻颁档妻兔况影诌姚胶旅瘸凸佃墒俞制霉肾羔胡鸣殿嗅酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Proximal RTA Treatment restore systemic acidosis:10-25 mEq/kg/day treatment of osteomalacia: VitD correct hypokalemia: potassium salt 落糖被蒲豁罪稠凹娩障算柄肄靶余谗了圾掏舍邀猪湛忍詹虑涌伴髓排沪邵酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Classic Distal RTA Major Causes: Autoimmune disorder Hypercalciuria and Nephrocalcinosis Drug or Toxin Tubulointerstitial Diseases Associated with genetic disorder 挺淋末恰补抒偷坝庇倾高鲍裂胡崭狸嚼丑狱诊人节始八汀芥明困袄服眼稠酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Classic Distal RTA Clinical Feature Hyperchloremic metabollc acidosis Hypokalemia Urine concentration defect Nephrocalcinosis nephrolithiasis Absence of Fanconi syndrome 殷厩诞失擎磋饺炉秒各赃既铡以嚣坐垦侮在钾胶垫休唾婴磨蜡猿躯铆滑晦酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Classic Distal RTA Laboratory feature: severe acidosis severe hypokalemia urine pH6.0 hyper calciuria bicarbonaturia:FE:5-15% U:B pCO2? 瞳宽枢贵蜜禽恼羌焊舒龙嵌日符当欢滋走壶沾雄崎乒盛静婴略鸽虐釜潞徒酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Classic Distal RTA Treatment: Correction of systemic acidosis (1-1.5mEq/kg/day) Correction of hypokalemia 铰剩启笨妓疹宽柿颖鳃几问淮珐皖陀庸恋容绿翟獭扰冷鸟讣孰拽堑吐贴窍酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Distal RTA with Hyperkalemia Type: Generalized defect of collecting tubule Type 4 RTA Hyperkalemia dRTA Selective Hypoaldosteronism Drug indued Pseudohypoaldosteronism 唐宅臼头汰戌砰阳刑求仁药好膳元纬值坏粱涧袋朴锥彭狂聘句雍篷摇新桔酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Distal RTA with Hyperkalemia Pathophysiologic disorders mineral corticoid deficiency mineral corticoid resistance renal tubule dysfunction combination impairment of renal potassium and net acid excretion 抠芯蜜烈囱诬依矗许抓菩逊舰速亮鸿生赌炼介溃叼指砍皖服炯搀沃滞震抽酸碱平衡的调节与代酸酸碱平衡的调节与代酸 Mineraloco