[Acid-base balance of the blood and possible renal mechanisms of its imbalance in children with oxalate-phosphate stones of the urinary tract].
A total of 191 children with oxalate-phosphate urinary concrements and 28 virtually healthy ones were studied for the main parameters of acid-base blood status with the use of Astrup's microtest. Besides, the urine circadian levels of acid and ammonium were followed up too. The proportion of the main and H+-secreting insertion cells of collecting tubes were calculated in 46 operative biopsy specimens, cells studied with electron microscopy. Advanced metabolic acidosis associated with a decrease in acid and ammonium titration was diagnosed in all patients with bilateral and in 81.6 per cent with unilateral nephrolithiasis. Regardless of acid-base blood status biopsy examination revealed a decrease in the number of insertion cells in renal collecting tubes of the patients mostly pronounced in those with bilateral concrement localization. Ultrastructure of insertion cells in children with oxalate-phosphate urolithiasis featured by a sharp decrease in mitochondria number, absence of smooth-walled vesicles, frequency of myelinoid lysosomes pointed to the failed competence of these cells to efficient H+ secretion. The data obtained evidence of the relationship between the metabolic acidosis and primary disability of the children's kidney to excrete H+.
Gontmakher
V M
VM
Iarmukhamedov
K Iu
KIu
D000136:Acid-Base Equilibrium; D000137:Acid-Base Imbalance / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D000293:Adolescent; D000818:Animals; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D006224:Cricetinae; D006801:Humans; D007223:Infant; D007672:Kidney Cortex / Q000648:ultrastructure; D007684:Kidney Tubules / Q000378:metabolism*; D007685:Kidney Tubules, Collecting / Q000378:metabolism* / Q000648:ultrastructure; D008854:Microscopy, Electron; D010070:Oxalates / Q000378:metabolism*; D010710:Phosphates / Q000378:metabolism*; D051381:Rats; D014545:Urinary Calculi / Q000150:complications / Q000378:metabolism* / Q000473:pathology
D010070:Oxalates; D010710:Phosphates
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