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肾小管性酸中毒的病理生理学及其对钾平衡的影响

Author
Michael Emmett, MD
Section Editor
Richard H Sterns, MD
Deputy Editor
John P Forman, MD, MSc
Translators
王颖, 主治医师

引言与分类

肾小管性酸中毒(renal tubular acidosis, RTA)主要有3种类型：远端RTA(Ⅰ型)、近端RTA(Ⅱ型)和高血钾型RTA。高血钾型RTA包括低醛固酮症(Ⅳ型)和一种称为电压依赖型RTA的疾病，后者有时也被认为是远端RTA的一种亚型。上述RTA主要类型在病理生理学及临床表现上存在差异(表 1)：

●远端RTA由远端肾小管氢离子排泄缺陷所致(表 2)

●近端RTA由造成近端肾小管重吸收滤过的碳酸氢盐能力下降的缺陷所致(表 3)

●低醛固酮症由醛固酮分泌减少或对醛固酮反应能力下降所致(表 4)

●电压依赖型RTA是由远端肾小管钠重吸收障碍所致

            

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Literature review current through: 2017-07 . | This topic last updated: 2015-06-30.
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