The pH of patient's blood is highly variable, and acidemia is not necessarily characteristic of sufferers of<unk>  at any given time. One may have<unk>  caused by alpha intercalated cell failure without necessarily being acidemic; termed incomplete<unk> , which is characterized by an inability to acidify urine, without affecting blood pH or plasma bicarbonate levels. The diagnosis of<unk>  can be made by the observation of a relatively alkaline urinary pH of greater than 5.3 in the face of a systemic acidemia (usually taken to be a serum bicarbonate of 20 mmol/L or less). In the case of an incomplete<unk> , failure to acidify the urine following an oral acid loading challenge is often used as a test. The test usually performed is the short ammonium chloride test, in which ammonium chloride capsules are used as the acid load. More recently, an alternative test using furosemide and fludrocortisone has been described.<unk>  has been proposed as a possible diagnosis for the unknown malady plaguing Tiny Tim in Charles Dickens' A Christmas Carol.
Distal renal tubular acidosis
Renal tubular acidosis
Proximal renal tubular acidosis
Isotonic hyponatremia
Hypotonic hyponatremia
Hyperchloremic acidosis
Cystinuria
Hyperosmolar syndrome