JAMES W. JEFFERSON, MD., F.A.C.P.
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To the editor: The comprehensive article by Bennett, Plamp, and Porter on "Drug-Related Syndromes in Clinical Nephrology" (1) did not mention that lithium can produce a defect in urinary acidification. In both animals and man a decreased ability to lower urinary pH in response to acid loading has been shown (2-5). This defect has been described as a partial distal renal tubular acidosis with lithium-induced impairment of distal tubular hydrogen-ion secretion (5). Although high doses of lithium have produced a systemic acidosis in dogs (3), this has not been demonstrated in man. It is conceivable that lithium treatment might make
JEFFERSON JW. Lithium and Metabolic Acidosis. Ann Intern Med. ;88:434. doi: 10.7326/0003-4819-88-3-434_1
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Published: Ann Intern Med. 1978;88(3):434.
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