Ammonium chloride load test

The ammonium chloride load test is a test to examine the function of distal renal tubules. For patients with suspected or incomplete renal tubular acidosis [type I], after two days of discontinuation of the alkaline drug, 0.1 g of oral ammonium chloride per kilogram of body weight can be administered in three divided doses for three consecutive days to acidify urine. liquid. Increase the burden of renal tubular excretion [H+], compare the urine pH before and after taking the drug; or take the above amount of ammonium chloride, and measure the urine pH once every 3 to 8 hours, the patient such as blood [HCO3-] has been reduced Below 20 meq/L, and the urine pH can not be reduced to below 5.5, it is positive for the test and valuable for diagnosing the disease. If the urine pH is less than 5.5, it is negative for the test. If the patient has liver disease and cannot use ammonium chloride, calcium chloride can be used instead. Basic Information Specialist classification: urinary examination classification: urine / kidney function test Applicable gender: whether men and women apply fasting: not fasting Tips: cirrhosis, liver function is obviously impaired, or there is already obvious metabolic acidosis, or active peptic ulcer or severe gastritis, banned. Normal value Urine pH < 5.3. Clinical significance Abnormal results: The ratio of the excretion of bicarbonate ions to the amount of excretion in the urine accounted for the total amount of filtration. Normal people have no bicarbonate ions in the urine, and the excretion fraction is 0, such as >15% (0.15), which can be diagnosed as proximal convolutic acidosis, and <5% (0.05) is far-curved tubule acidosis. People who need to be examined: suspected to be abnormal in renal tubular acidification. Precautions Contraindications before examination: Alkaline drugs should be discontinued 2 days before the test. Requirements for inspection: The pH should be measured immediately after collecting urine. Inspection process On the 1st and 3rd day, 0.1g (kg·d) of ammonium chloride was taken, and even served for 3 days. On the fourth day, urine was retained, and urine pH > 5.5 was positive. 2, 8h single-dose method of ammonium chloride 0.1g / kg, drinking water 500-600ml, 3 hours after 3 hours of urine retention, a total of 5 times, urine pH > 5.5 is positive. Not suitable for the crowd Inappropriate population: cirrhosis, liver function is obviously impaired, or there is already obvious metabolic acidosis, or active digestive new ulcer or severe gastritis, avoid the above test. Adverse reactions and risks No related complications or hazards.

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