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September 1949, Vol 78, No. 3 >
Case Reports | September 1949

NEPHROLITHIASIS WITH RENAL TUBULAR FAILURE

SYDNEY ISRAELS, M.D.; H. MUTH, M.D.; I. ZEAVIN, M.D.
Am J Dis Child. 1949;78(3):389-392. doi:10.1001/archpedi.1949.02030050402012.
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FAILURE of a single function of the renal tubules has been a well recognized entity. Thus, Thorn and his associates1 reported a case of "salt-losing nephritis" which so closely simulated adrenocortical hypofunction (Addison's disease) that it went unrecognized for some time. Albright and his co-workers2 gathered together and reported 9 cases of nephrolithiasis and nephrocalcinosis in which they showed that the primary defect lay in the inability of the renal tubules to form ammonia. This resulted in the loss of fixed base, with precipitation of calcium salts in the tubules and renal pelves. Loss of fixed base other than calcium may occur; potassium deficiency with resulting paralysis has been reported by Brown, Currens and Marchand3 in a case of chronic nephritis in which tubular formation of ammonia had failed.

The case presented herein shows many of the features of those described by Albright and his associates.

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