Hyperammonemia associated with distal renal tubular acidosis or urinary tract infection: a systematic review.

Background: Hyperammonemia usually results from an inborn error of metabolism or from an advanced liver disease. Individual case reports suggest that both distal renal tubular acidosis and urinary tract infection may also result in hyperammonemia.Methods: A systematic review of the literature on hyp...

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Publicado en:Pediatric Nephrology Vol. 33; no. 3; pp. 485 - 492
Autores principales: Clericetti, Caterina M., Milani, Gregorio P., Lava, Sebastiano A. G., Bianchetti, Mario G., Simonetti, Giacomo D., Giannini, Olivier
Formato: research systematic review tables/charts Journal Article
Publicado: Springer Nature Mar2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-017-3829-7
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        atl: Hyperammonemia associated with distal renal tubular acidosis or urinary tract infection: a systematic review.
      aug:
        au:
          Clericetti, Caterina M.
          Milani, Gregorio P.
          Lava, Sebastiano A. G.
          Bianchetti, Mario G.
          Simonetti, Giacomo D.
          Giannini, Olivier
        affil: Pediatric Department of Southern Switzerland, Bellinzona, Switzerland
      sug:
        subj:
          Hypoaldosteronism Etiology
          Metabolic Diseases Complications
          Systematic Review
          Human
          Urinary Tract Infections
          Hyperparathyroidism
          Ammonia Blood
          Bicarbonates Blood
          Anorexia
          Metabolic Diseases In Infancy and Childhood
          Metabolic Diseases In Adulthood
          Child
          Adult
          Child: 6-12 years
          Adult: 19-44 years
      ab: Background: Hyperammonemia usually results from an inborn error of metabolism or from an advanced liver disease. Individual case reports suggest that both distal renal tubular acidosis and urinary tract infection may also result in hyperammonemia.Methods: A systematic review of the literature on hyperammonemia secondary to distal renal tubular acidosis and urinary tract infection was conducted.Results: We identified 39 reports on distal renal tubular acidosis or urinary tract infections in association with hyperammonemia published between 1980 and 2017. Hyperammonemia was detected in 13 children with distal renal tubular acidosis and in one adult patient with distal renal tubular acidosis secondary to primary hyperparathyroidism. In these patients a negative relationship was observed between circulating ammonia and bicarbonate levels (<italic>P</italic> < 0.05). In 31 patients (19 children, 12 adults), an acute urinary tract infection was complicated by acute hyperammonemia and symptoms and signs of acute neuronal dysfunction, such as an altered level of consciousness, convulsions and asterixis, often associated with signs of brain edema, such as anorexia and vomiting. Urea-splitting bacteria were isolated in 28 of the 31 cases. The urinary tract was anatomically or functionally abnormal in 30 of these patients.Conclusions: This study reveals that both altered distal renal tubular acidification and urinary tract infection may be associated with relevant hyperammonemia in both children and adults.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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