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Urolithiasis pp 747–755Cite as

The Incidence of Nephrocalcinosis and the Urinary Excretion of Citrate and Calcium in Patients with Non-Azotemic type 4 Renal Tubular Acidosis

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Abstract

In infants and children with type 1 renal tubular acidosis (RTA) after chronic acidosis, short stature, stunting (height. < 2.5 SD from mean for age- and sex- matched normals) and nephrocalcinosis occur1–12. Nephrocalcinosis is invariable by age 4 years in children with type I RTA who are maintained on low-dose alkali therapy.(< 3 mEq/kg/d) since infancy1–6. Recently we have shown that nephrocalcinosis has not occurred over observation periods of 10–20 years in 7 children with type 1 RTA in whom sustained correction of acidosis with high dose alkali therapy (5-14 mEq/kg/d) was maintained since infancy7-9. In these children, we demonstrated that urinary excretion of citrate rose to normal values: whereas on low-dose alkali, < 3 mEq/kg/d, it remained subnormal7-9. Citrate is a chelator and complexor of urinary calcium and also, acts as an inhibitor of urinary crystal formation13,14.

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Author information

Authors and Affiliations

  1. Department of Pediatrics and Medicine, University of California San Francisco, San Francisco, CA, USA

    Elisabeth McSherry, Jay Gates & Maria Pialaet

Authors
  1. Elisabeth McSherry
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  2. Jay Gates
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  3. Maria Pialaet
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Editor information

Editors and Affiliations

  1. Mayo Clinic, Rochester, Minnesota, USA

    Lynwood H. Smith

  2. The General Infirmary, Leeds, England

    William G. Robertson

  3. University of Florida, Gainesville, Florida, USA

    Birdwell Finlayson

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© 1981 Springer Science+Business Media New York

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McSherry, E., Gates, J., Pialaet, M. (1981). The Incidence of Nephrocalcinosis and the Urinary Excretion of Citrate and Calcium in Patients with Non-Azotemic type 4 Renal Tubular Acidosis. In: Smith, L.H., Robertson, W.G., Finlayson, B. (eds) Urolithiasis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-8977-4_120

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  • DOI: https://doi.org/10.1007/978-1-4684-8977-4_120

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-8979-8

  • Online ISBN: 978-1-4684-8977-4

  • eBook Packages: Springer Book Archive

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