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??acute renal failure ARF???R????????????????????
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1????????????????
1???? 24?400ml??17ml??100ml24h??????????????1 020?2Ommo1L?????ARF??????????1.0101.012?40mmoIL????????????
2???????????????????????????????????????????????????????????????????????

3????????????????NPN?????????????????????????????????????????????
(4)?????????????????????????????????????????
(5) ????????????????????????????????????????????????????????????????
6????????????????????????714?27????????ARF?...

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1????
?????????????????????????????????????????????????????1.010~1.020??280mOsm/(kg?H2O)???CRF???????????? ??
2??????
(1)??
???????????????V???????????????????????????????????????????????? ?????
(2)???
???????125(OH)2D3???????????????????????
??????????D-125(OH)2D3?????????...

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???1.????????6070%???????????renaltubularacidosis????????????????????
2.????Cl-?Na+?1020%???????????????????????????
3.???????????H+K+NH3?Na+????????????????????????????????

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???CRF???
?(?)
    ?(GFR)8050ml/min(?CFR)?{(Scr)133177mol/L??????
?(?)
    ?(GFR) 5020ml/minScr186446mol/L)???????????????
(?)
    GFR 2010ml/minScr451707mol/L????????????????????
(????)
    GFR 10ml/minScr707mol/L

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???????????????????????????1.0151.030 ???????????????????????1.0100.003?
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(1)??????>171mol/L???????????ALT?????????;
(2)?????3?23????;
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6.??? ?????(2)??23????????28??
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