Renal tubular acidosis

Renal tubular acidosis

• inability to generate acid urine (secrete H+) in distal tubule
• causes hypokalaemia
  Renal tubular acidosis (types 1 and 2) causes hypokalaemia
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  Importance: 40
• complications include nephrocalcinosis
  Hypokalaemia, nephrocalcinosis - type 1 renal tubular acidosis
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  Importance: 58
  and renal stones
  Type 1 renal tubular acidosis (distal) complication - renal stones
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  Importance: 73
• causes include idiopathic, rheumatoid arthritis
  Type 1 renal tubular acidosis may be caused by rheumatoid arthritis
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  Importance: 14
  , SLE
  Type 1 renal tubular acidosis may be caused by SLE
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  Importance: 8
  , Sjogren's
  Type 1 (distal) renal tubular acidosis may be caused by Sjogren's syndrome
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  Importance: 66
  , amphotericin B toxicity, analgesic nephropathy

nephrocalcinosis

Hypokalaemia, nephrocalcinosis - type 1 renal tubular acidosis

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Importance: 58

- a classical finding in type 1 RTA">

Abdominal x-ray showing

Type 2 RTA (proximal

proximal

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)

• decreased HCO3- reabsorption in proximal tubule
• causes hypokalaemia
  Renal tubular acidosis (types 1 and 2) causes hypokalaemia
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  Importance: 40
• complications include osteomalacia
  Hypokalaemia, osteomalacia - type 2 renal tubular acidosis
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  Importance: 37
• causes include idiopathic, as part of Fanconi syndrome
  Type 2 renal tubular acidosis may be caused by Fanconi syndrome
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  Importance: 15
  , Wilson's diseas
  Wilson's diseas
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  e, cystinosis
  Type 2 renal tubular acidosis may be caused by cystinosis
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  Importance: 29
  , outdated tetracyclines, carbonic anhydrase inhibitors (acetazolamide, topiramate)

Type 3 RTA (mixed)

• extremely rare
• caused by carbonic anhydrase II deficiency
• results in hypokalaemia

Type 4 RTA (hyperkalaemic)

• reduction in aldosterone leads in turn to a reduction in proximal tubular ammonium excretion
• causes hyperkalaemia
  Renal tubular acidosis (type 4) causes hyperkalaemia
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  Importance: 15
• causes include hypoaldosteronism
  Type 4 renal tubular acidosis may be caused by hypoaldosteronism
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  Importance: 24
  , diabetes
  Type 4 renal tubular acidosis may be caused by diabetes mellitus
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  Importance: 41

+PassMedicine Notes

All three types of renal tubular acidosis (RTA) are associated with hyperchloraemic metabolic acidosis (normal anion gap).

Type 1 RTA (distal)

• inability to generate acid urine (secrete H+) in distal tubule
• causes hypokalaemia
• complications include nephrocalcinosis and renal stones
• causes include idiopathic, rheumatoid arthritis, SLE, Sjogren's, amphotericin B toxicity, analgesic nephropathy

Type 2 RTA (proximal)

• decreased HCO3- reabsorption in proximal tubule
• causes hypokalaemia
• complications include osteomalacia
• causes include idiopathic, as part of Fanconi syndrome, Wilson's disease, cystinosis, outdated tetracyclines, carbonic anhydrase inhibitors (acetazolamide, topiramate)

Type 3 RTA (mixed)

• extremely rare
• caused by carbonic anhydrase II deficiency
• results in hypokalaemia

Type 4 RTA (hyperkalaemic)

• reduction in aldosterone leads in turn to a reduction in proximal tubular ammonium excretion
• causes hyperkalaemia
• causes include hypoaldosteronism, diabetes

Media

Renal tubular acidosis

DirtyUSMLE - YouTube

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Renal tubular acidosis

Osmosis - YouTube

👍 227 👎 11

Renal tubular acidosis

YouTube

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Renal tubular acidosis

YouTube

👍 42 👎 9

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