About this episode

The episode discusses metabolic acidosis, focusing on Sjögren’s syndrome and its relation to distal renal tubular acidosis, along with various studies and case reports.

References Chapter 19, Part 3 August 30, 2023 Joel and Roger mentioned the most common cause seems to be Sjögren’s syndrome for an acquired distal RTA. We mentioned this in an earlier episode and referenced this example of an absence of the H+ ATPase, presumably from autoantibodies to this transporter. Here’s a case report: Absence of H(+)-ATPase in cortical collecting tubules of a patient with Sjogren's syndrome and distal renal tubular acidosis  Joel mentioned this paper in the New England Journal of Medicine in which there were patients who had hyperkalemia with a distal RTA: Hyperkalemic Distal Renal Tubular Acidosis Associated with Obstructive Uropathy | NEJM in this setting, some patients   Anna mentioned this article on “ampho-terrible:” It’s the holes!!!    Yano T, Itoh Y, Kawamura E, Maeda A, Egashira N, Nishida M, Kurose H, Oishi R. Amphotericin B-induced renal tubular cell injury is mediated by Na+ Influx through ion-permeable pores and subsequent activation of mitogen-activated protein kinases and elevation of intracellular Ca2+ concentration. Antimicrob Agents Chemother. 2009 Apr;53(4):1420-6 Josh mentioned this study on furosemide’s effect…

Topics covered

• metabolic acidosis
• renal tubular acidosis
• Sjögren’s syndrome
• hyperkalemia
• furosemide
• treatment of cystinosis

Keywords

• metabolic acidosis
• Sjögren’s syndrome
• distal renal tubular acidosis
• hyperkalemia
• furosemide
• renal tubular cell injury

Mentioned in this episode

Organizations: New England Journal of Medicine

Books & works: Absence of H(+)-ATPase in cortical collecting tubules of a patient with Sjogren's syndrome and distal renal tubular acidosis, Hyperkalemic Distal Renal Tubular Acidosis Associated with Obstructive Uropathy, Amphotericin B-induced renal tubular cell injury is mediated by Na+ Influx through ion-permeable pores and subsequent activation of mitogen-activated protein kinases and elevation of intracellular Ca2+ concentration, Furosemide-induced urinary acidification is caused by pronounced H+ secretion in the thick ascending limb, Expert guide

More episodes of Channel Your Enthusiasm

• Chapter Twenty One: Respiratory Alkalosis · March 24, 2026 · 1h 7m
• Chapter Nineteen: Metabolic Acidosis, part 2 · October 11, 2025 · 1h 45m
• Chapter Eighteen: Metabolic Alkalosis, part 2 · July 22, 2025 · 1h 40m
• Chapter Nineteen: Metabolic Acidosis, The Show, part 1 · June 1, 2025 · 1h 45m
• Chapter Eighteen: Metabolic Alkalosis, part 1 · March 23, 2025 · 1h 6m
• Chapter Seventeen: Introduction to Simple and Mixed Acid-Base Disorders · February 21, 2025 · 1h 32m

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