THE EFFECT OF A SINGLE ORAL DOSE OF THE CARBONIC ANHYDRASE INHIBITOR, ACETAZOLEAMIDE, IN RENAL DISEASE

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Abstract
The effect of a single oral dose of the carbonic anhydrase inhibitor, acetazoleamide, (2-acetylamino- l,3,4-thiadazole-5-sulfonamide), was studied in 15 patients with renal disease, 3 of whom had the syndrome of idiopathic renal tubular acidosis and in 4 normal controls. In normal subjects, there was an incrase in urine volume, rise in urine pH with Na, K and bicarbonate diuresis. This effect was also produced in patients with renal disease without acidosis but was smaller in magnitude. In the patients with renal disease and metabolic acidosis, the urinary changes were minimal or absent completely, while the patients with renal tubular acidosis showed urinary changes only after correction of the acidosis.'' Following production of ammonium chloride acidosis in 2 normal subjects, acetazoleamide failed to produce the customary urinary changes. The findings indicated that metabolic acidosis blocked the effect of acetazoleamide. The reasons for this and the possible therapeutic value of the drug in renal disease are discussed.