[Latent renal tubular acidosis of the cirrhotic patient. Study of urinary excretion of protons and sodium].
Patients suffering from hepatic cirrhosis develop renal tubular acidosis when subjected to an acid overload. This is characterised by a fall in plasma pH and bicarbonate and by inability of the kidney to lower urine pH and to excrete a sufficient quantity of protons in the form of titratable acidy and ammonia. This disturbance is difficult to explain. It may form part of the picture of the classical functional renal insufficiency of the cirrhotic and may be a particular result of altered renal haemodynamics. Detected by the acidification test, this abnormality may be demonstrated in the absence of any other involvement of renal function. The severity of this renal tubular acidosis would appear to be related to the degree of hepatic disease.