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Acidosis tubular renal proximal - Overview

Nombres alternativos

ATR tipo II; ATR proximal; Acidosis tubular renal tipo II

Definición:

Es una enfermedad que ocurre cuando los riñones no eliminan los ácidos apropiadamente en la orina, dejando la sangre demasiado ácida.

Causas, incidencia y factores de riesgo:

Los riñones ayudan a mejorar el equilibrio ácido-básico (pH) del cuerpo. Las sustancias ácidas en el cuerpo se neutralizan o amortiguan por medio de sustancias alcalinas, principalmente bicarbonato.

Los riñones contienen más de un millón de unidades de filtración llamadas nefronas. El bicarbonato es reabsorbido hacia la sangre en la parte inicial (proximal) del túbulo de cada nefrona. La acidosis tubular renal proximal (ATR tipo II) ocurre cuando los túbulos proximales no reabsorben apropiadamente el bicarbonato, dejando el cuerpo en estado ácido (llamado acidosis).

La ATR tipo II es menos común que la ATR tipo I, se presenta con más frecuencia durante la lactancia y puede desaparecer por sí sola.

Las causas de la ATR tipo II abarcan:

  • Cistinosis
  • Fármacos como ifosfamida (un fármaco quimioterapéutico), tetraciclina vencida, antibióticos aminoglucósidos o acetazolamida
  • Síndrome de Fanconi
  • Intolerancia hereditaria a la fructosa
  • Mieloma múltiple
  • Hiperparatiroidismo primario
  • Síndrome de Sjögren
  • Enfermedad de Wilson
  • Reviewed last on: 11/30/2009
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Herbert Y. Lin, MD, PHD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Seifter JL. Acid-base disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 119.

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