1型糖尿病合并高钾型肾小管酸中毒一例

Type 1 Diabetes Mellitus Combined with Hyperkalemic Renal Tubular Acidosis: One Case Report

高钾型肾小管酸中毒(RTA)以阴离子间隙正常的高氯性酸中毒及持续性高钾血症为主要特点,本病发病机制尚未完全清楚,醛固酮分泌减少或远端肾小管对醛固酮反应减弱,可能起重要致病作用。本文通过对1例1型糖尿病合并高钾型RTA患者的报道,并对其发病机制及相关生化指标做出分析讨论,旨在提高临床工作者对该病的察觉意识,对于临床上无严重肾功能衰竭而出现难以解释的高血钾患者,应想到高钾型RTA的可能。

Hyperkalemic renal tubular acidosis （RTA） is characterized by hyperchloremic acidosis and hypokalemia with normal anon gap. Given unclear pathogenesis, hypoaldosteronism or decreased response of distal renal tubule to aldosterone maybe play an important role. This article reports one case of type 1 diabetes mellitus combined with hyperkalemic RTA, and dis- cusses the pathogenesis and the related biochemical indicators. We hope to raise awareness of this disease among the clinical pro- fessionals - when unexplained hyperkalemia occurs to a patient without severe renal failure, hyperkalemic RTA should be consid- ered.