A 23-year-old woman presents with fatigue and recurrent nephrolithiasis. Vital signs show BP 128/82 mmHg, HR 88/min, RR 16/min, temperature 37°C. Laboratory studies reveal normal anion gap metabolic acidosis with pH 7.32, serum potassium 3.1 mEq/L, and urine pH 6.0 despite systemic acidosis. Serum calcium is elevated at 10.8 mg/dL. Urinalysis shows no hematuria. Which of the following is the most likely underlying defect?
- A)Decreased aldosterone effect in the collecting duct
- B)Increased chloride reabsorption in the thick ascending limb
- C)Excess ammonia generation in the proximal tubule
- D)Impaired hydrogen ion secretion in alpha intercalated cellsGABARITO
- E)Impaired bicarbonate reabsorption in the proximal tubule
Explicação
Impaired hydrogen ion secretion in alpha intercalated cells is correct. Distal or type 1 renal tubular acidosis results from failure of distal acid secretion, leading to an inappropriately high urine pH, hypokalemia, and increased risk of calcium phosphate sto... Ver explicação completa e trilha adaptativa →