Urolithiasis pp 747-755 | Cite as

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

  • Elisabeth McSherry
  • Jay Gates
  • Maria Pialaet


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.


Urinary Excretion Normal Child Urinary Calcium Renal Tubular Acidosis Fanconi Syndrome 
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Copyright information

© Springer Science+Business Media New York 1981

Authors and Affiliations

  • Elisabeth McSherry
    • 1
  • Jay Gates
    • 1
  • Maria Pialaet
    • 1
  1. 1.Department of Pediatrics and MedicineUniversity of California San FranciscoSan FranciscoUSA

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