Renal tubular acidosis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Renal tubular acidosis (RTA) is a clinical syndrome characterized by hyperchloremic metabolic acidosis with a normal serum anion gap.
Adult patients with RTA are often asymptomatic but may present with muscular weakness related to associated hypokalemia, nephrocalcinosis, or recurrent renal stones.
There are four types of RTA: classic distal RTA (type I), proximal RTA (type II), hyperkalemic distal RTA (type IV), and a rare combination of proximal and distal RTA caused by carbonic anhydrase II deficiency and carbonic anhydrase inhibitors blocking the metabolism of bicarbonate and carbonic acid (type III).
Alkali therapy is the mainstay of treatment in all forms of RTA.
If hyperkalemic distal RTA is due to mineralocorticoid deficiency, fludrocortisone can be given unless it is contraindicated due to the presence of fluid overload or uncontrolled hypertension.

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Definition

Epidemiology

Etiology

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Overview of blood and urine diagnostic tests in renal tubular acidosis

Citations

Key Articles

Palmer BF, Kelepouris E, Clegg DJ. Renal tubular acidosis and management strategies: a narrative review. Adv Ther. 2021 Feb;38(2):949-68.[Abstract][Full Text]
Kashoor I, Batlle D. Proximal renal tubular acidosis with and without Fanconi syndrome. Kidney Res Clin Pract. 2019 Sep 30;38(3):267-81.[Abstract][Full Text]
Giglio S, Montini G, Trepiccione F, et al. Distal renal tubular acidosis: a systematic approach from diagnosis to treatment. J Nephrol. 2021 Mar 26 [online ahead of print].[Abstract][Full Text]
Rodriguez Soriano J. Renal tubular acidosis: the clinical entity. J Am Soc Nephrol. 2002 Aug;13(8):2160-70.[Abstract][Full Text]
Batlle D, Arruda J. Hyperkalemic forms of renal tubular acidosis: clinical and pathophysiological aspects. Adv Chronic Kidney Dis. 2018 Jul;25(4):321-33.[Abstract]
Soleimani M, Rastegar A. Pathophysiology of renal tubular acidosis: core curriculum 2016. Am J Kidney Dis. 2016 Sep;68(3):488-98.[Abstract][Full Text]

Referenced Articles

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