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Department of Physiology and Biophysics, Weill Medical College of Cornell University, New York, New York 10021
The present clinical taxonomy of distal
renal tubular acidoses includes "gradient," "secretory," and
"voltage" defects. These categories refer to presumed collecting
duct defects in which the epithelium may be abnormally permeable and
unable to sustain an ion gradient, in which luminal proton ATPases are
defective, or in which electrogenic Na+ reabsorption is
impaired and luminal electronegativity is reduced. Classification of
affected individuals is based on urinary pH and ion concentrations
during spontaneous acidosis and during SO



distal renal tubular acidosis; renal acid excretion; urinary PCO2
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