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June 8, 1970

Renal Tubular Acidification in Rheumatoid Arthritis

Author Affiliations

Kaiser Foundation Hospital Oakland, Calif

JAMA. 1970;212(10):1707. doi:10.1001/jama.1970.03170230109028

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To the Editor.—  An acidification and concentration defect consistent with renal tubular acidosis has been reported in various disorders of immune activity, including Sjögren's syndrome (Ann Rheum Dis27:27, 1968), systemic lupus erythematosus (Ann Intern Med67:100, 1967), and renal homograft rejection (Amer J Med42:284, 1967). In view of the fact that rheumatoid arthritis often has many clinical and serological features in common with these conditions, it appeared reasonable to expect that an acidification defect might also be found in rheumatoid arthritis. Because of this probability, we have looked for evidence of renal tubular acidosis by means of an acute ammonium chloride loading test (Quart J Med28: 259, 1959) and a concentration test (Ann Intern Med67:100, 1967) in a group of 17 patients with rheumatoid arthritis.The group means for the rate of acid excretion per unit of creatinine clearance (titratable acid, 42μEq/