RENAL RESPONSE TO AMMONIUM CHLORIDE IN GLYCOSURIC OSTEOMALACIA*

Abstract

The response to chloride loading was studied in 3 patients with glycosuric osteomalacia. The response in one case of cystinosis was more suggestive of chronic renal disease than of an intrinsic tuDular defect. One patient demonstrated a mixture of the reabsorptive defects of the Fanconi syndrome and defective base conservation of renal hyperchloremic acidosis. In this case acid loading resulted in a lowering of urinary pH without enhancement of ammonium excretion. The third patient responded normally to acid-loading. Although the syndrome of renal hyperchloremic acidosis and the Fanconi syndrome appear to be closely related, it appears that a wide variety of tubular abnormalities have been too broadly grouped under the term Fanconi syndrome.