| Home | E-Submission | Sitemap | Contact Us |  
Korean J Intern Med > Volume 27(1); 2012 > Article
Kang, Kim, and Park: Biopsy-Proven Type 1 Renal Tubular Acidosis in a Patient with Metabolic Acidosis
A 44-year-old female was referred to our outpatient clinic with metabolic acidosis and vomiting. She had a history of toxic hepatitis, but no medications. On admission, her blood pressure was 120/70 mmHg with a pulse of 68 beats/min. The laboratory findings showed normal anion gap metabolic acidosis: Na 140 mmol/L, K 1.4 mmol/L, Cl 113 mmol/L, pH 7.192, and bicarbonate 12 mmol/L. The urine chemistry was pH 7.0, Na 55 mmol/L, K 14 mmol/L, and Cl 63 mmol/L (hyperchloremic metabolic acidosis of renal origin). Abdominal computed tomography revealed medullary nephrocalcinosis (Fig. 1). The renal pathology was non-specific. There was decreased net H+ secretion in the collecting tubules, resulting in a high urine pH. Acidification in the collecting tubules is primarily achieved via H secretion by luminal H+-ATPase. However, immunostaining for H+-ATPase was negative (Fig. 2). After alkali replacement with sodium bicarbonate, the serum bicarbonate recovered to above the lower normal limit (26.6 mmol/L). She was discharged in an improved condition.

Conflict of interest

No potential conflict of interest relevant to this article was reported.
Figure 1
Non-contrast computed tomography shows medullary nephrocalcinosis (arrows).
Figure 2
Immunostaining for aquaporin-2 and H+-ATPase in patient kidney (× 100). (A) Immunostaining for aquaporin-2 in principle cells of collecting tubule (arrows). (B) No immunostaining were observed in the collecting tubule (open arrows).
PDF Links  PDF Links
PubReader  PubReader
ePub Link  ePub Link
Full text via DOI  Full text via DOI
Full text via PMC  Full text via PMC
Download Citation  Download Citation
CrossRef TDM  CrossRef TDM
Related article
Editorial Office
101-2501, Lotte Castle President, 109 Mapo-daero, Mapo-gu, Seoul 04146, Korea
Tel: +82-2-2271-6792   Fax: +82-2-790-0993    E-mail: kaim@kams.or.kr
Copyright © 2018 The Korean Association of Internal Medicine. All rights reserved.
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
powerd by m2community